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Risk-adjusted capitation: Recent experiences in the Netherlands

By W.P.M.M. (Wynand) van de Ven, R.C.J.A. (René) van Vliet, E.M. (Erik) van Barneveld and L.M. (Leida) Lamers


The market-oriented health care reforms taking place in the Netherlands show a clear resemblance to the proposals for managed competition in U.S. health care. In both countries good risk adjustment mechanisms that prevent cream skimming--that is, that prevent plans from selecting the best health risks--are critical to the success of the reforms. In this paper we present an overview of the Dutch reforms and of our research concerning risk-adjusted capitation payments. Although we are optimistic about the technical possibilities for solving the problem of cream skimming, the implementation of good risk-adjusted capitation is a long-term challenge

Year: 1994
DOI identifier: 10.1377/hlthaff.13.5.120
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