The Effect of a Bonus Program for Preventive Health Behavior on Health Expenditures

This paper contributes to the analysis of policy measures that attempt to reduce health care expenditures of insurers. We examine the impact of a cash bonus program for preventive health behavior of a German health insurer on prevention effort and health care expenditures using a unique administrative dataset that covers all insurants of the health insurer between 2003 and 2008. We find that the program has been successful in both increasing individual prevention effort and achieving net savings every year since its implementation in 2004. However, while the estimated effect on health care expenditures is statistically significant in the first year, the effects for the second, third, and fourth years turn insignificant. In the fifth year, results for net savings are sensitive in terms of statistical significance when accounting for dynamic selection into the treatment