Nothing Special   »   [go: up one dir, main page]
IDEAS home Printed from https://ideas.repec.org/p/cpb/discus/327.html
   My bibliography  Save this paper

Does independent needs assessment limit supply-side moral hazard in long-term care?

Author

Listed:
  • Rudy Douven

    (CPB Netherlands Bureau for Economic Policy Analysis)

  • Pieter Bakx
  • Frederik T. Schut
Abstract
The decision about the amount and type of care that a patient needs may be entrusted to health care providers or be delegated to an independent assessor. An independent assessment limits the scope for supply-side moral hazard and occurs frequently in long-term care (LTC), e.g. in the Netherlands, Germany, Belgium, Switzerland, and Japan. The characteristics of LTC, the potential lack of incentives for efficient use for consumers, providers and third-party payers, and the absence of other restrictions of supply and demand, suggest that there may be room for excessive LTC use in the Netherlands, so there might be a case for independent needs assessment. Unique individual level data about LTC-eligibility decisions and use show that consumers make use of the indicated type of care but that for virtually all subgroups in the population there is considerable non-take-up, meaning that the independent assessment does not limit the amount of care that patients use. This finding suggests that the independent needs assessment may only have a small effect on preventing supply-side moral hazard in LTC.

Suggested Citation

  • Rudy Douven & Pieter Bakx & Frederik T. Schut, 2016. "Does independent needs assessment limit supply-side moral hazard in long-term care?," CPB Discussion Paper 327, CPB Netherlands Bureau for Economic Policy Analysis.
    • Handle: RePEc:cpb:discus:327
    as

    Download full text from publisher

    File URL: https://www.cpb.nl/sites/default/files/publicaties/download/cpb-discussion-paper-327-does-independent-needs-assessment-limit-supply-side-moral-hazard-long-term-.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Mark Kattenberg & Wouter Vermeulen, 2015. "The stimulative effect of an unconditional block grant on the decentralized provision of care," CPB Discussion Paper 308, CPB Netherlands Bureau for Economic Policy Analysis.
    2. Sophie Guthmuller & Florence Jusot & Jérôme Wittwer, 2014. "Improving Takeup of Health Insurance Program: A Social Experiment in France," Journal of Human Resources, University of Wisconsin Press, vol. 49(1), pages 167-194.
    3. Esther Mot, 2010. "The Dutch system of long-term care," CPB Document 204.rdf, CPB Netherlands Bureau for Economic Policy Analysis.
    4. Arrighi, Yves & Davin, Bérengère & Trannoy, Alain & Ventelou, Bruno, 2015. "The non-take up of long-term care benefit in France: A pecuniary motive?," Health Policy, Elsevier, vol. 119(10), pages 1338-1348.
    5. Peter Willemé & Joanna Geerts & Bea Cantillon & Ninke Mussche, 2012. "Long-Term Care Financing in Belgium," Palgrave Macmillan Books, in: Joan Costa-Font & Christophe Courbage (ed.), Financing Long-Term Care in Europe, chapter 16, pages 300-321, Palgrave Macmillan.
    6. Mark Kattenberg & Wouter Vermeulen, 2015. "The stimulative effect of an unconditional block grant on the decentralized provision of care," CPB Discussion Paper 308.rdf, CPB Netherlands Bureau for Economic Policy Analysis.
    7. repec:dau:papers:123456789/9715 is not listed on IDEAS
    8. Joan Costa-Font & Christophe Courbage (ed.), 2012. "Financing Long-Term Care in Europe," Palgrave Macmillan Books, Palgrave Macmillan, number 978-0-230-34919-3, December.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Maaike Diepstraten & Rudy Douven & Bram Wouterse, 2019. "Can your house keep you out of a nursing home?," CPB Discussion Paper 397.rdf, CPB Netherlands Bureau for Economic Policy Analysis.
    2. Bakx, Pieter & Wouterse, Bram & van Doorslaer, Eddy & Wong, Albert, 2020. "Better off at home? Effects of nursing home eligibility on costs, hospitalizations and survival," Journal of Health Economics, Elsevier, vol. 73(C).
    3. Marielle Non, 2017. "Co-payments in long-term home care: do they affect the use of care?," CPB Discussion Paper 363, CPB Netherlands Bureau for Economic Policy Analysis.
    4. Daisy Duell & Maarten Lindeboom & Xander Koolman & France Portrait, 2019. "Practice variation in long‐term care access and use: The role of the ability to pay," Health Economics, John Wiley & Sons, Ltd., vol. 28(11), pages 1277-1292, November.
    5. Maaike Diepstraten & Rudy Douven & Bram Wouterse, 2019. "Can your house keep you out of a nursing home?," CPB Discussion Paper 397, CPB Netherlands Bureau for Economic Policy Analysis.
    6. Marielle Non, 2017. "Co-payments in long-term home care: do they affect the use of care?," CPB Discussion Paper 363.rdf, CPB Netherlands Bureau for Economic Policy Analysis.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Rudy Douven & Pieter Bakx & Frederik T. Schut, 2016. "Does independent needs assessment limit supply-side moral hazard in long-term care?," CPB Discussion Paper 327.rdf, CPB Netherlands Bureau for Economic Policy Analysis.
    2. Bakx, Pieter & Douven, Rudy & Schut, Frederik T., 2021. "Does independent needs assessment limit use of publicly financed long-term care?," Health Policy, Elsevier, vol. 125(1), pages 41-46.
    3. Pieter Bakx & Frederik Schut & Eddy Doorslaer, 2015. "Can universal access and competition in long-term care insurance be combined?," International Journal of Health Economics and Management, Springer, vol. 15(2), pages 185-213, June.
    4. Mark Kattenberg & Pieter Bakx, 2018. "Are substitute services a barrier to controlling long-term care expenditures?," CPB Discussion Paper 382.rdf, CPB Netherlands Bureau for Economic Policy Analysis.
    5. Sandrine Juin, 2016. "Care for dependent elderly people : dealing with health and financing issues," Erudite Ph.D Dissertations, Erudite, number ph16-02 edited by Thomas Barnay.
    6. Mark Kattenberg & Pieter Bakx, 2018. "Are substitute services a barrier to controlling long-term care expenditures?," CPB Discussion Paper 382, CPB Netherlands Bureau for Economic Policy Analysis.
    7. Joan COSTA‐FONT & Christophe Courbage & Katherine Swartz, 2015. "Financing Long‐Term Care: Ex Ante, Ex Post or Both?," Health Economics, John Wiley & Sons, Ltd., vol. 24(S1), pages 45-57, March.
    8. Quitterie Roquebert & Jonathan Sicsic & Thomas Rapp, 2021. "Health measures and long-term care use in the European frail population," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(3), pages 405-423, April.
    9. Rapp, Thomas & Ronchetti, Jérome & Sicsic, Jonathan, 2022. "Impact of formal care consumption on informal care use in Europe: What is happening at the beginning of dependency?," Health Policy, Elsevier, vol. 126(7), pages 632-642.
    10. Marianne Tenand, 2018. "Being dependent rather than handicapped in France: Does the institutional barrier at 60 affect care arrangements?," Working Papers halshs-01889452, HAL.
    11. Chiara Canta & Helmuth Cremer, 2021. "Opting out and topping up reconsidered: Informal care under uncertain altruism," Canadian Journal of Economics/Revue canadienne d'économique, John Wiley & Sons, vol. 54(1), pages 259-283, February.
    12. Lindeboom, Maarten & van der Klaauw, Bas & Vriend, Sandra, 2015. "The effect of audit regimes on applications for long-term care," CEPR Discussion Papers 10572, C.E.P.R. Discussion Papers.
    13. Justina Klimaviciute & Pierre Pestieau & Jérôme Schoenmaeckers, 2019. "Family altruism and long-term care insurance," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 44(2), pages 216-230, April.
    14. Rellstab, Sara & Bakx, Pieter & García-Gómez, Pilar & van Doorslaer, Eddy, 2020. "The kids are alright - labour market effects of unexpected parental hospitalisations in the Netherlands," Journal of Health Economics, Elsevier, vol. 69(C).
    15. Christophe Courbage & Guillem Montoliu-Montes & Joël Wagner, 2020. "The effect of long-term care public benefits and insurance on informal care from outside the household: empirical evidence from Italy and Spain," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(8), pages 1131-1147, November.
    16. Maurizio Bussolo & Johannes Koettl & Emily Sinnott, 2015. "Golden Aging," World Bank Publications - Books, The World Bank Group, number 22018.
    17. Quitterie Roquebert & Remi Kabore & Jerome Wittwer, 2018. "Decentralized policies and formal care use by the disabled elderly," PSE Working Papers halshs-01877829, HAL.
    18. Joan Costa-Font & Martin Karlsson & Henning Øien, 2015. "Informal Care and the Great Recession," CINCH Working Paper Series 1502, Universitaet Duisburg-Essen, Competent in Competition and Health, revised Feb 2015.
    19. Canta, Chiara & Cremer, Helmuth, 2018. "Uncertain Altruism and Non-Linear Long-Term Care Policies," IZA Discussion Papers 11619, Institute of Labor Economics (IZA).
    20. Vincenzo Atella & Federico Belotti & Ludovico Carrino & Andrea Piano Mortari, 2017. "The future of Long Term Care in Europe. An investigation using a dynamic microsimulation model," CEIS Research Paper 405, Tor Vergata University, CEIS, revised 08 May 2017.

    More about this item

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • L13 - Industrial Organization - - Market Structure, Firm Strategy, and Market Performance - - - Oligopoly and Other Imperfect Markets
    • L33 - Industrial Organization - - Nonprofit Organizations and Public Enterprise - - - Comparison of Public and Private Enterprise and Nonprofit Institutions; Privatization; Contracting Out

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:cpb:discus:327. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: the person in charge (email available below). General contact details of provider: https://edirc.repec.org/data/cpbgvnl.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.