Theoretical and empirical occurence of cream-skimming - Evaluating Health Choice Skåne
(2011) NEKM01 20112Department of Economics
- Abstract
- The Swedish primary health care market has recently undergone a care choice reform where patients are allowed to choose which provider to be listed at. It has also opened up the market for private primary health care providers to a larger extent and a more competitive structure is created where capitation, a prospective and fixed reimbursement method, to varying degrees is used as a mean of provider reimbursement. Possible gains in efficiency and cost containment has to be weighed against the adverse incentives caused by capitation such as cream-skimming of patient according to individual characteristics and under-provision of medical services to all patients.
The theoretical and empirical occurrence of cream-skimming following the care... (More) - The Swedish primary health care market has recently undergone a care choice reform where patients are allowed to choose which provider to be listed at. It has also opened up the market for private primary health care providers to a larger extent and a more competitive structure is created where capitation, a prospective and fixed reimbursement method, to varying degrees is used as a mean of provider reimbursement. Possible gains in efficiency and cost containment has to be weighed against the adverse incentives caused by capitation such as cream-skimming of patient according to individual characteristics and under-provision of medical services to all patients.
The theoretical and empirical occurrence of cream-skimming following the care choice reform in Region Skåne, Health Choice Skåne, is what is being evaluated in this essay. The main findings are that the design of Health Choice Skåne provides some incentives for cream-skimming as almost all of the reimbursement is made up by capitation, a method not supported by the health economic literature. The empirical analysis does not give support of cream-skimming or other marginalizing behavior taking place on behalf of high-need patients or between public- and private health care centers. If anything, the case seems to be the opposite and the distribution of primary health care visits are now more equal with private health care centers, in general, acquiring a larger proportion of patients in high need of health care. (Less)
Please use this url to cite or link to this publication:
http://lup.lub.lu.se/student-papers/record/2201476
- author
- Axelsson, Johan LU
- supervisor
-
- Ulf Gerdtham LU
- organization
- course
- NEKM01 20112
- year
- 2011
- type
- H1 - Master's Degree (One Year)
- subject
- keywords
- Provider reimbursement, Health Choice Skåne, Health Economics, Cream-skimming
- language
- English
- id
- 2201476
- date added to LUP
- 2011-11-11 13:45:07
- date last changed
- 2011-11-11 13:45:07
@misc{2201476, abstract = {{The Swedish primary health care market has recently undergone a care choice reform where patients are allowed to choose which provider to be listed at. It has also opened up the market for private primary health care providers to a larger extent and a more competitive structure is created where capitation, a prospective and fixed reimbursement method, to varying degrees is used as a mean of provider reimbursement. Possible gains in efficiency and cost containment has to be weighed against the adverse incentives caused by capitation such as cream-skimming of patient according to individual characteristics and under-provision of medical services to all patients. The theoretical and empirical occurrence of cream-skimming following the care choice reform in Region Skåne, Health Choice Skåne, is what is being evaluated in this essay. The main findings are that the design of Health Choice Skåne provides some incentives for cream-skimming as almost all of the reimbursement is made up by capitation, a method not supported by the health economic literature. The empirical analysis does not give support of cream-skimming or other marginalizing behavior taking place on behalf of high-need patients or between public- and private health care centers. If anything, the case seems to be the opposite and the distribution of primary health care visits are now more equal with private health care centers, in general, acquiring a larger proportion of patients in high need of health care.}}, author = {{Axelsson, Johan}}, language = {{eng}}, note = {{Student Paper}}, title = {{Theoretical and empirical occurence of cream-skimming - Evaluating Health Choice Skåne}}, year = {{2011}}, }