Page 74 - Effective healthcare cost containment policies Using the Netherlands as a case study - Niek W. Stadhouders

Coordination (Case management)
Phillips et al., 2014
Pre-post-reform- comparison
USA
In Illinois, a case management program (IHC) from 2006 was associated with a reduction in costs of 6.5% per year to 2010. A separate disease management program (YHP) resulted in costs savings of 8.6%.
Maximal savings of the Arkansas primary care case management program were 6.7% (1991-1995). Access to care increased.
Cv Sb 3 1
Cb Mb R 3 3 3
Policy
Paper
Method
Coordination (Provider continuity) Competition (Insurers)
De Maeseneer et al., 2003
Multivariate regression analysis
OLS regression analysis
BEL
Patients switching GP were 11% more expensive than patients with GP continuity.
Cv Sb 2 1
Cb Mb R 1 1 1
Competition (hospitals)
Merrill et al., 1986 Gaynor et al., 2013
D-in-D
No significant cost-saving effect was found as a result of increased competition policies in 2006. Some positive quality effects were observed.
Muller et al., 1996 Hawkins et al., 2015
Stepped wedge panel analysis D-in-D and propensity matching Logistic and OLS regressions
USA USA
A case management program for high-risk patients, implemented between 2008 and 2011, is estimated to have a ROI of 1.40.
Cv Sb 2 1 Cv Sb 1 1
Cb Mb R 3 2 2 Cb Mb R 1 1 1
Ozminkowski et al., 1999
USA
A health management program implemented by Citibank in 1994 resulted in cost savings of between $589 and $626 per participant and a positive ROI of between 4.56 and 4.73.
A non-significant reduction of $89 PMPM is found for high-risk patients in a case management program in Georgia. These reductions were insufficient to cover the costs of the program.
Cv Sb 2 1
Cb Mb R 1 2 1
Kranker, 2016
D-in-D in a natural experiment
USA
Cv Sb 2 3
Cb Mb R 2 2 3
Melnick et al., 1988
USA
Costs in California regions with low degree of competition increased by 1% between 1983 and 1985, while costs decreased by 11.3% in highly competitive regions.
California, having a pro-competitive legislature, achieved lower cost growth than states with regulatory environments between 1980 and 1991.
Cv Sb 1 1
Cb Mb R 2 1 2
Melnick et al., 1995
state comparison
USA
Cv Sb 2 1
Cb Mb R 1 2 1
Mobley, 1998
First differences estimation Linear regression
USA USA GBR
In the long term, California’s pro-competitive reform lowered costs, but might have jeopardized public hospital continuity (1982-1990).
No significant difference in expenditure between states relying on regulation and states relying on competition was found.
Cv Sb 2 3 Cv Sb 1 1 Cv Sb 3 3
Cb Mb R 2 3 3 Cb Mb R 3 2 2 Cb Mb R 3 3 3
Market conduct policies
Country Effect Assessment*