Cost-Sharing Design Matters: A Comparison of the Rebate and Deductible in Healthcare

Jan Boone, Minke Remmerswaal, Michiel Bijlsma and Rudy Douven

No 12507, CEPR Discussion Papers from C.E.P.R. Discussion Papers

Abstract: Since 2006, the Dutch population has faced two different cost-sharing schemes in health insurance for curative care: a mandatory rebate of 255 euros in 2006 and 2007, and since 2008 a mandatory deductible. Using administrative data for the entire Dutch population, we compare the effect of both cost-sharing schemes on healthcare consumption between 2006 and 2013. We use a regression discontinuity design which exploits the fact that persons younger than eighteen years old neither face a rebate nor a deductible. Our fixed effect estimate shows that for individuals around the age of eighteen, a one euro increase of the deductible reduces healthcare expenditures 18 eurocents more than a euro increase of the rebate. These results demonstrate that differences in the design of a cost-sharing scheme can lead to substantial different effects on total healthcare expenditure.

Keywords: Deductible; Rebate; Cost-sharing; Healthcare consumption; Regression discontinuity design; Panel data (search for similar items in EconPapers)
Date: 2017-12
New Economics Papers: this item is included in nep-eur, nep-hea and nep-ias
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Citations: View citations in EconPapers (3)

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