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A structural microsimulation model for demand-side cost-sharing in healthcare.

Jan Boone1, Minke Remmerswaal2

  • 1Department of Economics, Tilburg University, The Netherlands; CPB Netherlands Bureau for Economic Policy Analysis, The Hague, The Netherlands; CEPR, London, United Kingdom.

Journal of Health Economics
|June 12, 2024
PubMed
Summary
This summary is machine-generated.

Increasing healthcare deductibles can lower overall spending and reduce patient out-of-pocket costs. A higher deductible, like 400 euros instead of 300 euros, significantly cuts healthcare expenditure and out-of-pocket payments.

Keywords:
Bayesian mixture modelCo-insuranceMicrosimulation modelMoral hazardOut-of-pocketShifted deductible

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Area of Science:

  • Health Economics
  • Public Health Policy
  • Econometrics

Background:

  • Demand-side cost-sharing in healthcare aims to mitigate moral hazard.
  • However, it concurrently escalates patient exposure to out-of-pocket expenditures.
  • Balancing these effects is crucial for effective healthcare policy.

Purpose of the Study:

  • To develop and apply a structural microsimulation model.
  • To evaluate the impact of various cost-sharing schemes on total and out-of-pocket healthcare expenditure.
  • To inform policy decisions regarding healthcare financing.

Main Methods:

  • Utilized a structural microsimulation model for policy evaluation.
  • Employed a Bayesian mixture model to represent healthcare expenditure distributions.
  • Estimated the model using comprehensive Dutch healthcare data.
  • Simulated policy outcomes for diverse cost-sharing scenarios.

Main Results:

  • A shift in the deductible's starting point from 300 to 400 euros reduced average healthcare expenditure by 4%.
  • This policy change also resulted in a 47% decrease in out-of-pocket payments.
  • The findings highlight the significant impact of deductible design on healthcare costs.

Conclusions:

  • Adjusting cost-sharing parameters, specifically deductibles, can effectively manage healthcare expenditure.
  • Optimizing deductible levels offers a dual benefit of reduced overall spending and lower financial burden on individuals.
  • Microsimulation modeling provides a robust framework for assessing healthcare policy interventions.