Health Economics Seminars (EUR)

Martin Salm (University of Tilburg)
Thursday, March 30, 2017

We examine three aspects of behavioral responses to patient co-payment schemes in the Netherlands: 1) How does the framing of cost-sharing incentives as deductibles or as no-claims rebates affect health care utilization? 2) How does patient cost-sharing affect the demand for care which does not fall under the co-payment such as GP care? 3) How do responses to patient co-payments differ between socio-economic groups?  Our study is based on administrative claims-level data from a Dutch health insurer for the years 2006 until 2015. We find that patients reduce healthcare utilization in response to both no-claim rebates and deductibles. However, the response to deductible payments is much stronger than to no-claim rebates. Further, patient co-payments significantly reduce demand for GP care even though GP care is exempted from patient co-payments. The response to co-payments is stronger in zip-codes with lower average income.