Hoofd onderzoeksafdeling Organisatie en Sturing in de Zorg; programmaleider Zorgstelsel en Sturing; bijzonder hoogleraar Zorgstelsel en Sturing CAPHRI, Universiteit Maastricht
Publicatie
Preferred providers: insurants’ opinions on channelling by health insurers.
Jong, J.D. de, Bes, R., Reitsma-van Rooijen, M. Preferred providers: insurants’ opinions on channelling by health insurers. European Journal of Public Health: 2010, 20(suppl. 1), p. 142. Abstract. 3rd European Public Health Conference 'Integrated Public Health', 10 - 13 November 2010, Amsterdam.
Background: In the past decades, health-care reforms have been implemented in several countries. A general aspect of most of these reforms is the shift from a supply-oriented system to a demand- oriented system. In several countries these reforms were based on introducing managed competition. In these systems of managed competition, insurers can selectively contract with health care providers or point out preferred providers. In order to make the system work, insurers should somehow channel their insured to these providers. In this study, we focused on insurants’ opinions on channelling by health insurers. Methods: Questionnaires were sent to 1559 members of the Dutch Health Care Consumer Panel and to 3418 members of the Insurants Panel in 2009. The questionnaire was returned by 1056 members of the Consumer Panel (response 68%) and by 2223 members of the Insurants Panel (response 65%). Among other things, opinions were asked on situations where insurers ask insurants to go to another health care provider. A discrete choice experiment was used to find out whether positive financial incentives could be effective in channelling insurants to preferred providers. Results: Results show that it depends on the type of care whether insurants are positive or negative about channelling by their insurer. Furthermore, financial incentives seem to be effective in stimulating insurants to go to preferred providers, only if the general practitioner (GP) does not have a preference for another provider and the distance to a preferred provider is not longer than the distance to the usual provider. Conclusions: This study shows that when there is a personal relationship with the health care provider, namely with a GP or dentist, people are less positive about channelling by health insurers. For drugs they are more positive. Furthermore, the GP plays an important role in choices patients make. Therefore, it is difficult for insurers to channel their insurants to preferred providers. Positive financial incentives can be effective, but the GP is still most important. (aut. ref.)
Background: In the past decades, health-care reforms have been implemented in several countries. A general aspect of most of these reforms is the shift from a supply-oriented system to a demand- oriented system. In several countries these reforms were based on introducing managed competition. In these systems of managed competition, insurers can selectively contract with health care providers or point out preferred providers. In order to make the system work, insurers should somehow channel their insured to these providers. In this study, we focused on insurants’ opinions on channelling by health insurers. Methods: Questionnaires were sent to 1559 members of the Dutch Health Care Consumer Panel and to 3418 members of the Insurants Panel in 2009. The questionnaire was returned by 1056 members of the Consumer Panel (response 68%) and by 2223 members of the Insurants Panel (response 65%). Among other things, opinions were asked on situations where insurers ask insurants to go to another health care provider. A discrete choice experiment was used to find out whether positive financial incentives could be effective in channelling insurants to preferred providers. Results: Results show that it depends on the type of care whether insurants are positive or negative about channelling by their insurer. Furthermore, financial incentives seem to be effective in stimulating insurants to go to preferred providers, only if the general practitioner (GP) does not have a preference for another provider and the distance to a preferred provider is not longer than the distance to the usual provider. Conclusions: This study shows that when there is a personal relationship with the health care provider, namely with a GP or dentist, people are less positive about channelling by health insurers. For drugs they are more positive. Furthermore, the GP plays an important role in choices patients make. Therefore, it is difficult for insurers to channel their insurants to preferred providers. Positive financial incentives can be effective, but the GP is still most important. (aut. ref.)
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