A Model to Estimate the Impact of Thresholds and Caps on Coverage Levels in Community-based Health Insurance Schemes in Low-Income Countries

David Dror

Chapter 11 in Financing Micro Health Insurance:Theory, Methods and Evidence, 2018, pp 203-221 from World Scientific Publishing Co. Pte. Ltd.

Abstract: The following sections are included:Knowledge of the distribution of health care costs is essential in order to match costs with local levels of willingness-to-pay (WTP) for health insurance (HI), in order to predict (simulate) the expected performance of the community-based health insurance (CBHI).This knowledge of the distribution makes it possible to determine at the stage of package design the optimal levels of thresholds and/or caps for each benefit-type included.A theoretical model was built, fitted with data obtained from 11 household surveys conducted between 2008 and 2010 in rural locations (9 in India and 2 in Nepal).The mean cost and probability of health care utilization in the 11 locations were very different, yet the standardized distributions of expenditures on hospitalization and tests in the 11 locations were very similar.The model could be applied more generally.

Keywords: Microinsurance; Micro Health Insurance; Health Insurance; Community-Based Health Insurance; CBHI; Demand for Health Insurance; Willingness to Pay for Health Insurance; Microinsurance Package Design; Implementation of CBHI; Business Case of Microinsurance (search for similar items in EconPapers)
JEL-codes: I13 I15 (search for similar items in EconPapers)
Date: 2018
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