Provider responses to discontinuous tariffs: evidence from Dutch rehabilitation care

Katalin Gaspar () and Xander Koolman ()
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Katalin Gaspar: Talma Institute/VU University Amsterdam
Xander Koolman: Talma Institute/VU University Amsterdam

International Journal of Health Economics and Management, 2022, vol. 22, issue 3, No 5, 333-354

Abstract: Abstract Abrupt jumps in reimbursement tariffs have been shown to lead to unintended effects in physicians’ behavior. A sudden change in tariffs at a pre-defined point in the treatment can incentivize health care providers to prolong treatment to reach the higher tariff, and then to discharge patients once the higher tariff is reached. The Dutch reimbursement schedule in hospital rehabilitation care follows a two-threshold stepwise-function based on treatment duration. We investigated the prevalence of strategic discharges around the first threshold and assessed whether their share varies by provider type. Our findings suggest moderate response to incentives by traditional care providers (general and academic hospitals, rehabilitation centers and multicategorical providers), and strong response by profit-oriented independent treatment centers. When examining the variation in response based on the financial position of the organization, we found a higher probability of manipulation among providers in financial distress. Our findings provide multiple insights and possible indicators to identify provider types that may be more prone to strategic behavior.

Keywords: Provider payment; Provider incentive; Policy evaluation; Regulated competition; The Netherlands (search for similar items in EconPapers)
JEL-codes: I11 I13 I18 (search for similar items in EconPapers)
Date: 2022
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Citations: View citations in EconPapers (1)

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DOI: 10.1007/s10754-021-09322-5

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