Health Insurance Exchanges In Switzerland And The Netherlands Offer Five Key Lessons For The Operations Of US Exchanges.
Since the 1990s some European countries have had regulated health insurance exchanges or have incorporated elements of exchange markets into their health systems. Health reforms in Switzerland and the Netherlands in 1996 and 2006, respectively, created managed competition in the countries' health in...
| Published in: | Health Affairs Vol. 32; no. 4; pp. 744 - 753 |
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| Main Authors: | , , |
| Format: | Journal Article |
| Published: |
Health Affairs Publishing, LLC
Apr2013
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=86873366&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 86873366 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 02782715 HAF jtl: Health Affairs issn: 02782715 maglogo: N pubinfo: dt: Apr2013 vid: 32 iid: 4 pid: 1453 pub: Health Affairs Publishing, LLC place: Washington, District of Columbia artinfo: ui: 86873366 108003142 10.1377/hlthaff.2012.0948 86873366 ppf: 744 ppct: 9 formats: tig: atl: Health Insurance Exchanges In Switzerland And The Netherlands Offer Five Key Lessons For The Operations Of US Exchanges. aug: au: Van Ginneken, Ewout Swartz, Katherine Van Der Wees, Philip affil: Senior Research, Department of Health Care Management at the Berlin University of Technology, Germany sug: subj: Insurance, Health Standards Insurance, Health Standards Managed Competition Insurance Carriers Health Services Switzerland Netherlands Government Regulations Patient Protection and Affordable Care Act Risk Management Methods Cost Control Financial Support Methods Negotiation Fees and Charges Quality of Health Care Patient Classification Insurance Benefits Standards Contract Services Methods Rate Setting and Review Access to Information Decision Making, Patient ab: Since the 1990s some European countries have had regulated health insurance exchanges or have incorporated elements of exchange markets into their health systems. Health reforms in Switzerland and the Netherlands in 1996 and 2006, respectively, created managed competition in the countries' health insurance markets, which are somewhat analogous to the US state and federally operated health insurance exchanges scheduled to begin operations in 2013 under the Affordable Care Act. We review the Swiss and Dutch experience with exchanges and offer specific lessons for the US exchanges. First, risk-adjustment mechanisms-which provide premium adjustments intended to compensate health plans for enrolling people expected to have high medical costs-need to be sophisticated and continually updated. Second, it is important to determine why people eligible for coverage don't enroll and to craft responses that will overcome enrollment barriers. Third, applying for subsidies must be simple. Fourth, insurers will need bargaining power similar to that of providers to create a level playing field for negotiating about prices and quality of services, and interim cost containment measures may be necessary. Fifth and finally, insurers and consumers alike will need meaningful information about providers' costs and quality of care so they can become prudent purchasers of health services, since managed competition among health plans by itself will not substantially drive down health costs. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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