Page 36 - Effective healthcare cost containment policies Using the Netherlands as a case study - Niek W. Stadhouders

Chapter 2
nineteen nineties, before entering into a steep decline. This seems to correspond with the rise and fall of managed care practices in the US. Recently, many studies cover payment reform illustrating the search towards new reimbursement mechanisms that include elements of quality and outcome schemes (figure 2.4a). We witness a declining number of studies into capacity regulations and benefits (figure 2.4b).
a
0,18 0,16 0,14 0,12
0,1 0,08 0,06 0,04 0,02 0
b
0,18 0,16 0,14 0,12
0,1 0,08 0,06 0,04 0,02 0
0,2 third party payer
0,2 capacity control
appropriateness
cost sharing
benefit package
Figure 2.4: The moving 5-year average trends of highly covered containment strategies in the literature: a) market oriented policies and b) volume control strategies.
We categorized health systems as public provision or market-based provision systems based on the classification of Joumard (OECD, 2011), as the study classifies most OECD member countries into two equal-sized groups. The US was considered as a third type of system characterized by a high level of private insurance (Böhm et al., 2013). Using this classification, we found that countries relying on market based provision attract more policy suggestions for cost containment than public provision countries (see Appendix table 2.2).
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structure
provider structure
payment reform
competition