E. Schut - Academia.edu (original) (raw)

Papers by E. Schut

Social Policy and Administration, 2010

The Netherlands was the first country that introduced a universal mandatory social health insuran... more The Netherlands was the first country that introduced a universal mandatory social health insurance scheme for covering a broad range of long-term care (LTC) services provided in a variety of care settings. Compared with most other OECD countries, both total and public expenditure on LTC is high, particularly since the Dutch population is relatively young. On the other hand, coverage of LTC services is relatively comprehensive. In this article we examine the past experiences, current deficiencies and future prospects of LTC financing in the Netherlands. By rationing of supply and tight budgetary restrictions, the government managed to effectively control the growth of LTC expenditure, but at the expense of growing waiting lists and deteriorating quality of care. Reform plans aim to make the LTC system more efficient and consumer-directed. We discuss whether the proposed reforms offer a perspective on a sustainable system of comprehensive LTC insurance. This is especially important in view of the ageing of the population and the expected increase in demand for LTC services. We conclude that the success of the reforms heavily depends on the definition of entitlements, the accuracy of needs assessment and the feasibility of determining appropriate client-based budgets.

Doel: Op basis van feitelijk keuzegedrag van verzekerden is onderzocht of verzekerden gevoelig zi... more Doel: Op basis van feitelijk keuzegedrag van verzekerden is onderzocht of verzekerden gevoelig zijn voor kwaliteitsverschillen tussen verzekeraars en of de CQI-score een relevante graadmeter is voor de kwaliteit van zorgverzekeraars. Opzet:

The European journal of health economics : HEPAC : health economics in prevention and care, Jan 28, 2015

We examine the impact of price, service quality and information search on people's propensity... more We examine the impact of price, service quality and information search on people's propensity to switch health insurers in the competitive Dutch health insurance market. Using panel data from annual household surveys and data on health insurers' premiums and quality ratings over the period 2006-2012, we estimate a random effects logit model of people's switching decisions. We find that switching propensities depend on health plan price and quality, and on people's age, health, education and having supplementary or group insurance. Young people (18-35 years) are more sensitive to price, whereas older people are more sensitive to quality. Searching for health plan information has a much stronger impact on peoples' sensitivity to price than to service quality. In addition, searching for health plan information has a stronger impact on the switching propensity of higher than lower educated people, suggesting that higher educated people make better use of available he...

Advances in Health Economics and Health Services Research, 2010

To analyse the development of pharmaceutical policy in the Dutch market for outpatient prescripti... more To analyse the development of pharmaceutical policy in the Dutch market for outpatient prescription drugs since the early 1990s. A literature review and document analysis is performed to examine the effects of pharmaceutical policy on the performance of the Dutch market for outpatient prescription drugs since the early 1990s. Government efforts to control prices of pharmaceuticals were effective in constraining prices of in-patent drugs, but had an opposite effect on the prices of generic drugs. The gradual transition towards managed competition--that particularly gained momentum after the introduction of the new universal health insurance scheme in 2006--appears to be more effective in constraining prices of generic drugs than earlier government efforts to control these prices. Comparative analysis of the impact of price regulation and managed competition on generic drug prices in the Netherlands. Implications of the changing role of health insurers are discussed for the future market for prescription drugs and role of pharmacies in the Netherlands.

Health Services Research, 2011

To effectively bargain about the price and quality of health services, health insurers need to su... more To effectively bargain about the price and quality of health services, health insurers need to successfully channel their enrollees. Little is known about consumer sensitivity to different channeling incentives. In particular, the impact of status quo bias, which is expected to differ between different provider types, can play a large role in insurers' channeling ability. Objective. To examine consumer sensitivity to channeling strategies and to analyze the impact of status quo bias for different provider types. Data Sources/Study Design. With a large-scale discrete choice experiment, we investigate the impact of channeling incentives on choices for pharmacies and general practitioners (GPs). Survey data were obtained among a representative Dutch household panel (n 5 2,500). Principal Findings. Negative financial incentives have a two to three times larger impact on provider choice than positive ones. Positive financial incentives have a relatively small impact on GP choice, while the impact of qualitative incentives is relatively large. Status quo bias has a large impact on provider choice, which is more prominent in the case of GPs than in the case of pharmacies. Conclusion. The large impact of the status quo bias makes channeling consumers away from their current providers a daunting task, particularly in the case of GPs.

Health Economics, 2008

Consumer channeling is an important element in the insurer-provider bargaining process. Health in... more Consumer channeling is an important element in the insurer-provider bargaining process. Health insurers can influence provider choice by offering insurance contracts with restricted provider networks. Alternatively, they can offer contracts with unrestricted access and use incentives to motivate consumers to visit preferred providers. Little is known, however, about the effectiveness of this alternative strategy of consumer channeling. Using data from two natural experiments in the Dutch pharmacy market, we examine how consumers respond to incentives used by health insurers to influence their choice of provider. We find that consumers are sensitive to rather small incentives and that temporary incentives may sort a long-term effect on provider choice. In addition, we find that both consumer and provider characteristics determine whether consumers are willing to switch to preferred pharmacies.

Economisch Statistische Berichten, 2009

De auteur heeft verklaard dit artikel alleen te publiceren in ESB en niet elders te publiceren in... more De auteur heeft verklaard dit artikel alleen te publiceren in ESB en niet elders te publiceren in wat voor medium dan ook. Het is wel toegestaan om het artikel voor eigen gebruik en voor publicatie op een intranet van de werkgever van de auteur aan te wenden.

International Journal of Health Care Finance and Economics, 2008

Aim To estimate the price sensitivity of consumer choice of health insurance firm. Method Using p... more Aim To estimate the price sensitivity of consumer choice of health insurance firm. Method Using paneldata of the flows of insured between pairs of Dutch sickness funds during the period 1993-2002, we estimate the sensitivity of these flows to differences in insurance premium. Results The price elasticity of residual demand for health insurance was low during the period 1993-2002, confirming earlier findings based on annual changes in market share. We find small but significant elasticities for basic insurance but insignificant elasticities for supplementary insurance. Young enrollees are more price sensitive than older enrollees. Conclusion Competition was weak in the market for health insurance during the period under study. For the market-based reforms that are currently under way, this implies that measures to promote competition in the health insurance industry may be needed.

In de nieuwe zorgverzekering onderhandelen zorgverzekeraars met zorgaanbieders over de kwaliteit ... more In de nieuwe zorgverzekering onderhandelen zorgverzekeraars met zorgaanbieders over de kwaliteit en de prijs van de te leveren zorg. Het is de bedoeling dat zorgverzekeraars mede op basis van de gecontracteerde kwaliteit van zorg met elkaar gaan concurreren op de zorgverzekeringsmarkt. Inzicht in de preferenties van consumenten is daarbij cruciaal. Dit onderzoek presenteert de resultaten van een vignettenstudie waarmee de stated preferences van individuen voor de hoogte van de verzekeringspremie, de kwaliteit van dienstverlening en de kwaliteit van de door zorgverzekeraars gecontracteerde zorg worden gemeten. In het onderzoek wordt voorts empirisch getoetst of mensen met een chronische aandoening andere preferenties hebben ten aanzien van hun zorgverzekeraar dan mensen zonder chronische aandoening. De vignettenstudie laat zien dat zowel mensen met als zonder chronische aandoening bereid zijn een hogere premie te betalen als zorgverzekeraars objectief zouden kunnen aantonen dat dankzij hun zorginkoop/contracteerbeleid verzekerden bij bepaalde aandoeningen een grotere kans hebben op een verbetering van hun gezondheid. Het kan dus lonen voor een zorgverzekeraar om te investeren in de kwaliteit van zorg, mits hij de opbrengst van deze investeringen duidelijk kan maken en op dit terrein een reputatie kan verwerven. Meer procesmatige aspecten van zorgverlening en service aspecten van de zorgverzekeraar spelen een minder belangrijke rol.

Health Economics Policy and Law, Dec 2, 2010

We investigate the impact of the transition towards managed competition in the Dutch health care ... more We investigate the impact of the transition towards managed competition in the Dutch health care system on health insurers' contracting behaviour. Specifically, we examine whether insurers have been able to take up their role as prudent buyers of care and examine consumers' attitudes towards insurers' new role. Health insurers' contracting behaviour is investigated by an extensive analysis of available information on purchasing practices by health insurers and by interviews with directors of health care purchasing of the four major health insurers, accounting for 90% of the market. Consumer attitudes towards insurers' new role are investigated by surveys among a representative sample of enrollees over the period 2005-2009. During the first four years of the reform, health insurers were very reluctant to engage in selective contracting and preferred to use 'soft' positive incentives to encourage preferred provider choice rather than engaging in restrictive managed care activities. Consumer attitudes towards channelling vary considerably by type of provider but generally became more negative in the first two years after the reform. Insurers' reluctance to use selective contracting can be at least partly explained by the presence of a credible-commitment problem. Consumers do not trust that insurers with restrictive networks are committed to provide good quality care. The credible-commitment problem seems to be particularly relevant to the Netherlands, since Dutch enrollees are not used to restrictions on provider choice. Since consumers are quite sensitive to differences in provider quality, more reliable information about provider quality is required to reduce the credible-commitment problem.

ABSTRACT Efficient contracting of health care requires effective consumer channeling. Little is k... more ABSTRACT Efficient contracting of health care requires effective consumer channeling. Little is known about the effectiveness of channeling strategies. We study channeling incentives on pharmacy choice using a large scale discrete choice experiment. Financial incentives prove to be effective. Positive financial incentives are less effective than negative financial incentives. Channeling through qualitative incentives also leads to a significant impact on provider choice. While incentives help to channel, a strong status quo bias needs to be overcome before consumers change pharmacies. Focusing on consumers who are forced to choose a new pharmacy seems to be the most effective strategy.

Health Services Research Impacting Health Practice and Policy Through State of the Art Research Thinking, Oct 1, 2010

To effectively bargain about the price and quality of health services, health insurers need to su... more To effectively bargain about the price and quality of health services, health insurers need to successfully channel their enrollees. Little is known about consumer sensitivity to different channeling incentives. In particular, the impact of status quo bias, which is expected to differ between different provider types, can play a large role in insurers' channeling ability. Objective. To examine consumer sensitivity to channeling strategies and to analyze the impact of status quo bias for different provider types. Data Sources/Study Design. With a large-scale discrete choice experiment, we investigate the impact of channeling incentives on choices for pharmacies and general practitioners (GPs). Survey data were obtained among a representative Dutch household panel (n 5 2,500). Principal Findings. Negative financial incentives have a two to three times larger impact on provider choice than positive ones. Positive financial incentives have a relatively small impact on GP choice, while the impact of qualitative incentives is relatively large. Status quo bias has a large impact on provider choice, which is more prominent in the case of GPs than in the case of pharmacies. Conclusion. The large impact of the status quo bias makes channeling consumers away from their current providers a daunting task, particularly in the case of GPs.

De auteur heeft verklaard dit artikel alleen te publiceren in ESB en niet elders te publiceren in... more De auteur heeft verklaard dit artikel alleen te publiceren in ESB en niet elders te publiceren in wat voor medium dan ook. Het is wel toegestaan om het artikel voor eigen gebruik en voor publicatie op een intranet van de werkgever van de auteur aan te wenden.

Het eerste dat opvalt aan het overzicht in Tabel 1 is dat alle verzekeraars voldoende tot goed sc... more Het eerste dat opvalt aan het overzicht in Tabel 1 is dat alle verzekeraars voldoende tot goed scoren. Enkele verzekeraars krijgen een 8 of hoger van hun verzekerden.

International Journal of Health Care Finance and Economics, 2009

Efficient contracting of health care requires effective consumer channeling. Little is known abou... more Efficient contracting of health care requires effective consumer channeling. Little is known about the effectiveness of channeling strategies. We study channeling incentives on pharmacy choice using a large scale discrete choice experiment. Financial incentives prove to be effective. Positive financial incentives are less effective than negative financial incentives. Channeling through qualitative incentives also leads to a significant impact on provider choice. While incentives help to channel, a strong status quo bias needs to be overcome before consumers change pharmacies. Focusing on consumers who are forced to choose a new pharmacy seems to be the most effective strategy.

Complete document available on OLIS in its original format This document and any map included her... more Complete document available on OLIS in its original format This document and any map included herein are without prejudice to the status of or sovereignty over any territory, to the delimitation of international frontiers and boundaries and to the name of any territory, city or area. 2 Unclassified English -Or. English ECO/WKP(2013)2 2

International Journal of Health Care Finance and Economics, 2008

Aim To estimate the price sensitivity of consumer choice of health insurance firm. Method Using p... more Aim To estimate the price sensitivity of consumer choice of health insurance firm. Method Using paneldata of the flows of insured between pairs of Dutch sickness funds during the period 1993-2002, we estimate the sensitivity of these flows to differences in insurance premium. Results The price elasticity of residual demand for health insurance was low during the period 1993-2002, confirming earlier findings based on annual changes in market share. We find small but significant elasticities for basic insurance but insignificant elasticities for supplementary insurance. Young enrollees are more price sensitive than older enrollees. Conclusion Competition was weak in the market for health insurance during the period under study. For the market-based reforms that are currently under way, this implies that measures to promote competition in the health insurance industry may be needed.

International Journal of Health Care Finance and Economics, 2009

Efficient contracting of health care requires effective consumer channeling. Little is known abou... more Efficient contracting of health care requires effective consumer channeling. Little is known about the effectiveness of channeling strategies. We study channeling incentives on pharmacy choice using a large scale discrete choice experiment. Financial incentives prove to be effective. Positive financial incentives are less effective than negative financial incentives. Channeling through qualitative incentives also leads to a significant impact on provider choice. While incentives help to channel, a strong status quo bias needs to be overcome before consumers change pharmacies. Focusing on consumers who are forced to choose a new pharmacy seems to be the most effective strategy.

Social Policy and Administration, 2010

The Netherlands was the first country that introduced a universal mandatory social health insuran... more The Netherlands was the first country that introduced a universal mandatory social health insurance scheme for covering a broad range of long-term care (LTC) services provided in a variety of care settings. Compared with most other OECD countries, both total and public expenditure on LTC is high, particularly since the Dutch population is relatively young. On the other hand, coverage of LTC services is relatively comprehensive. In this article we examine the past experiences, current deficiencies and future prospects of LTC financing in the Netherlands. By rationing of supply and tight budgetary restrictions, the government managed to effectively control the growth of LTC expenditure, but at the expense of growing waiting lists and deteriorating quality of care. Reform plans aim to make the LTC system more efficient and consumer-directed. We discuss whether the proposed reforms offer a perspective on a sustainable system of comprehensive LTC insurance. This is especially important in view of the ageing of the population and the expected increase in demand for LTC services. We conclude that the success of the reforms heavily depends on the definition of entitlements, the accuracy of needs assessment and the feasibility of determining appropriate client-based budgets.

Doel: Op basis van feitelijk keuzegedrag van verzekerden is onderzocht of verzekerden gevoelig zi... more Doel: Op basis van feitelijk keuzegedrag van verzekerden is onderzocht of verzekerden gevoelig zijn voor kwaliteitsverschillen tussen verzekeraars en of de CQI-score een relevante graadmeter is voor de kwaliteit van zorgverzekeraars. Opzet:

The European journal of health economics : HEPAC : health economics in prevention and care, Jan 28, 2015

We examine the impact of price, service quality and information search on people's propensity... more We examine the impact of price, service quality and information search on people's propensity to switch health insurers in the competitive Dutch health insurance market. Using panel data from annual household surveys and data on health insurers' premiums and quality ratings over the period 2006-2012, we estimate a random effects logit model of people's switching decisions. We find that switching propensities depend on health plan price and quality, and on people's age, health, education and having supplementary or group insurance. Young people (18-35 years) are more sensitive to price, whereas older people are more sensitive to quality. Searching for health plan information has a much stronger impact on peoples' sensitivity to price than to service quality. In addition, searching for health plan information has a stronger impact on the switching propensity of higher than lower educated people, suggesting that higher educated people make better use of available he...

Advances in Health Economics and Health Services Research, 2010

To analyse the development of pharmaceutical policy in the Dutch market for outpatient prescripti... more To analyse the development of pharmaceutical policy in the Dutch market for outpatient prescription drugs since the early 1990s. A literature review and document analysis is performed to examine the effects of pharmaceutical policy on the performance of the Dutch market for outpatient prescription drugs since the early 1990s. Government efforts to control prices of pharmaceuticals were effective in constraining prices of in-patent drugs, but had an opposite effect on the prices of generic drugs. The gradual transition towards managed competition--that particularly gained momentum after the introduction of the new universal health insurance scheme in 2006--appears to be more effective in constraining prices of generic drugs than earlier government efforts to control these prices. Comparative analysis of the impact of price regulation and managed competition on generic drug prices in the Netherlands. Implications of the changing role of health insurers are discussed for the future market for prescription drugs and role of pharmacies in the Netherlands.

Health Services Research, 2011

To effectively bargain about the price and quality of health services, health insurers need to su... more To effectively bargain about the price and quality of health services, health insurers need to successfully channel their enrollees. Little is known about consumer sensitivity to different channeling incentives. In particular, the impact of status quo bias, which is expected to differ between different provider types, can play a large role in insurers' channeling ability. Objective. To examine consumer sensitivity to channeling strategies and to analyze the impact of status quo bias for different provider types. Data Sources/Study Design. With a large-scale discrete choice experiment, we investigate the impact of channeling incentives on choices for pharmacies and general practitioners (GPs). Survey data were obtained among a representative Dutch household panel (n 5 2,500). Principal Findings. Negative financial incentives have a two to three times larger impact on provider choice than positive ones. Positive financial incentives have a relatively small impact on GP choice, while the impact of qualitative incentives is relatively large. Status quo bias has a large impact on provider choice, which is more prominent in the case of GPs than in the case of pharmacies. Conclusion. The large impact of the status quo bias makes channeling consumers away from their current providers a daunting task, particularly in the case of GPs.

Health Economics, 2008

Consumer channeling is an important element in the insurer-provider bargaining process. Health in... more Consumer channeling is an important element in the insurer-provider bargaining process. Health insurers can influence provider choice by offering insurance contracts with restricted provider networks. Alternatively, they can offer contracts with unrestricted access and use incentives to motivate consumers to visit preferred providers. Little is known, however, about the effectiveness of this alternative strategy of consumer channeling. Using data from two natural experiments in the Dutch pharmacy market, we examine how consumers respond to incentives used by health insurers to influence their choice of provider. We find that consumers are sensitive to rather small incentives and that temporary incentives may sort a long-term effect on provider choice. In addition, we find that both consumer and provider characteristics determine whether consumers are willing to switch to preferred pharmacies.

Economisch Statistische Berichten, 2009

De auteur heeft verklaard dit artikel alleen te publiceren in ESB en niet elders te publiceren in... more De auteur heeft verklaard dit artikel alleen te publiceren in ESB en niet elders te publiceren in wat voor medium dan ook. Het is wel toegestaan om het artikel voor eigen gebruik en voor publicatie op een intranet van de werkgever van de auteur aan te wenden.

International Journal of Health Care Finance and Economics, 2008

Aim To estimate the price sensitivity of consumer choice of health insurance firm. Method Using p... more Aim To estimate the price sensitivity of consumer choice of health insurance firm. Method Using paneldata of the flows of insured between pairs of Dutch sickness funds during the period 1993-2002, we estimate the sensitivity of these flows to differences in insurance premium. Results The price elasticity of residual demand for health insurance was low during the period 1993-2002, confirming earlier findings based on annual changes in market share. We find small but significant elasticities for basic insurance but insignificant elasticities for supplementary insurance. Young enrollees are more price sensitive than older enrollees. Conclusion Competition was weak in the market for health insurance during the period under study. For the market-based reforms that are currently under way, this implies that measures to promote competition in the health insurance industry may be needed.

In de nieuwe zorgverzekering onderhandelen zorgverzekeraars met zorgaanbieders over de kwaliteit ... more In de nieuwe zorgverzekering onderhandelen zorgverzekeraars met zorgaanbieders over de kwaliteit en de prijs van de te leveren zorg. Het is de bedoeling dat zorgverzekeraars mede op basis van de gecontracteerde kwaliteit van zorg met elkaar gaan concurreren op de zorgverzekeringsmarkt. Inzicht in de preferenties van consumenten is daarbij cruciaal. Dit onderzoek presenteert de resultaten van een vignettenstudie waarmee de stated preferences van individuen voor de hoogte van de verzekeringspremie, de kwaliteit van dienstverlening en de kwaliteit van de door zorgverzekeraars gecontracteerde zorg worden gemeten. In het onderzoek wordt voorts empirisch getoetst of mensen met een chronische aandoening andere preferenties hebben ten aanzien van hun zorgverzekeraar dan mensen zonder chronische aandoening. De vignettenstudie laat zien dat zowel mensen met als zonder chronische aandoening bereid zijn een hogere premie te betalen als zorgverzekeraars objectief zouden kunnen aantonen dat dankzij hun zorginkoop/contracteerbeleid verzekerden bij bepaalde aandoeningen een grotere kans hebben op een verbetering van hun gezondheid. Het kan dus lonen voor een zorgverzekeraar om te investeren in de kwaliteit van zorg, mits hij de opbrengst van deze investeringen duidelijk kan maken en op dit terrein een reputatie kan verwerven. Meer procesmatige aspecten van zorgverlening en service aspecten van de zorgverzekeraar spelen een minder belangrijke rol.

Health Economics Policy and Law, Dec 2, 2010

We investigate the impact of the transition towards managed competition in the Dutch health care ... more We investigate the impact of the transition towards managed competition in the Dutch health care system on health insurers' contracting behaviour. Specifically, we examine whether insurers have been able to take up their role as prudent buyers of care and examine consumers' attitudes towards insurers' new role. Health insurers' contracting behaviour is investigated by an extensive analysis of available information on purchasing practices by health insurers and by interviews with directors of health care purchasing of the four major health insurers, accounting for 90% of the market. Consumer attitudes towards insurers' new role are investigated by surveys among a representative sample of enrollees over the period 2005-2009. During the first four years of the reform, health insurers were very reluctant to engage in selective contracting and preferred to use 'soft' positive incentives to encourage preferred provider choice rather than engaging in restrictive managed care activities. Consumer attitudes towards channelling vary considerably by type of provider but generally became more negative in the first two years after the reform. Insurers' reluctance to use selective contracting can be at least partly explained by the presence of a credible-commitment problem. Consumers do not trust that insurers with restrictive networks are committed to provide good quality care. The credible-commitment problem seems to be particularly relevant to the Netherlands, since Dutch enrollees are not used to restrictions on provider choice. Since consumers are quite sensitive to differences in provider quality, more reliable information about provider quality is required to reduce the credible-commitment problem.

ABSTRACT Efficient contracting of health care requires effective consumer channeling. Little is k... more ABSTRACT Efficient contracting of health care requires effective consumer channeling. Little is known about the effectiveness of channeling strategies. We study channeling incentives on pharmacy choice using a large scale discrete choice experiment. Financial incentives prove to be effective. Positive financial incentives are less effective than negative financial incentives. Channeling through qualitative incentives also leads to a significant impact on provider choice. While incentives help to channel, a strong status quo bias needs to be overcome before consumers change pharmacies. Focusing on consumers who are forced to choose a new pharmacy seems to be the most effective strategy.

Health Services Research Impacting Health Practice and Policy Through State of the Art Research Thinking, Oct 1, 2010

To effectively bargain about the price and quality of health services, health insurers need to su... more To effectively bargain about the price and quality of health services, health insurers need to successfully channel their enrollees. Little is known about consumer sensitivity to different channeling incentives. In particular, the impact of status quo bias, which is expected to differ between different provider types, can play a large role in insurers' channeling ability. Objective. To examine consumer sensitivity to channeling strategies and to analyze the impact of status quo bias for different provider types. Data Sources/Study Design. With a large-scale discrete choice experiment, we investigate the impact of channeling incentives on choices for pharmacies and general practitioners (GPs). Survey data were obtained among a representative Dutch household panel (n 5 2,500). Principal Findings. Negative financial incentives have a two to three times larger impact on provider choice than positive ones. Positive financial incentives have a relatively small impact on GP choice, while the impact of qualitative incentives is relatively large. Status quo bias has a large impact on provider choice, which is more prominent in the case of GPs than in the case of pharmacies. Conclusion. The large impact of the status quo bias makes channeling consumers away from their current providers a daunting task, particularly in the case of GPs.

De auteur heeft verklaard dit artikel alleen te publiceren in ESB en niet elders te publiceren in... more De auteur heeft verklaard dit artikel alleen te publiceren in ESB en niet elders te publiceren in wat voor medium dan ook. Het is wel toegestaan om het artikel voor eigen gebruik en voor publicatie op een intranet van de werkgever van de auteur aan te wenden.

Het eerste dat opvalt aan het overzicht in Tabel 1 is dat alle verzekeraars voldoende tot goed sc... more Het eerste dat opvalt aan het overzicht in Tabel 1 is dat alle verzekeraars voldoende tot goed scoren. Enkele verzekeraars krijgen een 8 of hoger van hun verzekerden.

International Journal of Health Care Finance and Economics, 2009

Efficient contracting of health care requires effective consumer channeling. Little is known abou... more Efficient contracting of health care requires effective consumer channeling. Little is known about the effectiveness of channeling strategies. We study channeling incentives on pharmacy choice using a large scale discrete choice experiment. Financial incentives prove to be effective. Positive financial incentives are less effective than negative financial incentives. Channeling through qualitative incentives also leads to a significant impact on provider choice. While incentives help to channel, a strong status quo bias needs to be overcome before consumers change pharmacies. Focusing on consumers who are forced to choose a new pharmacy seems to be the most effective strategy.

Complete document available on OLIS in its original format This document and any map included her... more Complete document available on OLIS in its original format This document and any map included herein are without prejudice to the status of or sovereignty over any territory, to the delimitation of international frontiers and boundaries and to the name of any territory, city or area. 2 Unclassified English -Or. English ECO/WKP(2013)2 2

International Journal of Health Care Finance and Economics, 2008

Aim To estimate the price sensitivity of consumer choice of health insurance firm. Method Using p... more Aim To estimate the price sensitivity of consumer choice of health insurance firm. Method Using paneldata of the flows of insured between pairs of Dutch sickness funds during the period 1993-2002, we estimate the sensitivity of these flows to differences in insurance premium. Results The price elasticity of residual demand for health insurance was low during the period 1993-2002, confirming earlier findings based on annual changes in market share. We find small but significant elasticities for basic insurance but insignificant elasticities for supplementary insurance. Young enrollees are more price sensitive than older enrollees. Conclusion Competition was weak in the market for health insurance during the period under study. For the market-based reforms that are currently under way, this implies that measures to promote competition in the health insurance industry may be needed.

International Journal of Health Care Finance and Economics, 2009

Efficient contracting of health care requires effective consumer channeling. Little is known abou... more Efficient contracting of health care requires effective consumer channeling. Little is known about the effectiveness of channeling strategies. We study channeling incentives on pharmacy choice using a large scale discrete choice experiment. Financial incentives prove to be effective. Positive financial incentives are less effective than negative financial incentives. Channeling through qualitative incentives also leads to a significant impact on provider choice. While incentives help to channel, a strong status quo bias needs to be overcome before consumers change pharmacies. Focusing on consumers who are forced to choose a new pharmacy seems to be the most effective strategy.