Economic impact of disease prevention in a morbidity-based financing system: does prevention pay off for a statutory health insurance fund in Germany?

Ines Weinhold, Christian Schindler (), Nils Kossack, Benjamin Berndt and Dennis Häckl
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Ines Weinhold: WIG2 Scientific Institute for Health Economics and Health System Research
Christian Schindler: WIG2 Scientific Institute for Health Economics and Health System Research
Nils Kossack: WIG2 Scientific Institute for Health Economics and Health System Research
Benjamin Berndt: WIG2 Scientific Institute for Health Economics and Health System Research
Dennis Häckl: WIG2 Scientific Institute for Health Economics and Health System Research

The European Journal of Health Economics, 2019, vol. 20, issue 8, No 6, 1193 pages

Abstract: Abstract Preventable chronic diseases account for the greatest burden in the German health system and statutory health insurance (SHI) funds play a crucial role in implementing and financing prevention strategies. On the contrary, the morbidity-based scheme to distribute financial resources from the Central Reallocation Pool among the different sickness funds may counteract efforts of effective prevention from an economic perspective. We assessed financial impacts of prevention from a sickness funds perspective in a retrospective controlled study. Claims data of 6,247,275 persons were analyzed and outcomes between two propensity-matched groups (n = 852,048) of prevention users and non-users were compared in a 4-year follow-up. Using a difference-in-differences approach, we analyzed healthcare expenditures, the development of morbidity, financial transfers from the Central Reallocation Pool, and contribution margins. The group of prevention users develops less morbidity (incidences and disease aggravations) compared to the control group. Healthcare expenditures increase in both groups within 4 years, whereas the increase is lower for prevention users compared to non-users (€568.04 vs. €640.60, p

Keywords: Prevention; Healthcare financing; Incentives; Regulation; Competition (search for similar items in EconPapers)
JEL-codes: I10 I13 I18 (search for similar items in EconPapers)
Date: 2019
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Citations: View citations in EconPapers (1)

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DOI: 10.1007/s10198-019-01086-7

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