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

Michiel Bijlsma, Jan Boone, Rudy Douven and Minke Remmerswaal

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: cost-sharing; deductible; healthcare consumption; panel data; rebate; regression discontinuity design (search for similar items in EconPapers)
New Economics Papers: this item is included in nep-eur, nep-hea and nep-ias
Date: 2017-12
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