The Risk Adjustment Reform Act of 2001 mandates that a health-status-based risk adjustment mechanism has to be implemented in Germany's Statutory Health Insurance system by January 1, 2007. German parliament decided this as with the existing demographic risk adjustment model, that means there is...

If health care expenditure for the elderly grows faster than for younger people, the expenditure profiles become "steeper" – we call that "steeping". Three instruments for measuring "steeping" are presented: (1) trend of the relation between per-capita-expenditure of the old and the young; (2)...

Das Bundesministerium für Gesundheit hat die Verfasser mit dem Gutachten zur Umsetzung und empirischen Abschätzung der Übergangsregelungen zur Einführung des Gesundheits-fonds (§ 272 SGB V) beauftragt. Die Verfasser haben am 01. April 2008 den Entwurf des Gutachtens vorgelegt. Es bestand...

An important goal of risk-adjusted capitation payments (RACPs) to competitive community-rated health plans—that may differ in coverage and/or the organisation of delivering care—is to reduce incentives for risk selection while maintaining incentives for efficiency. In most schemes, RACPs are...

From the mid-1990s several countries have introduced elements of regulated competition in healthcare. The aim of this paper is to identify the most important preconditions for achieving efficiency and affordability under regulated competition in healthcare, and to indicate to what extent these...

In Germany risk adjustment is a core element of the regulatory framework of competition between sickness funds. It shall create a level playing field between funds with very heterogeneous risk structures. Prior to 2009 risk adjustment was mainly by a demographic model. In 2009 morbidity based...

Health care systems are financed through a mixture of different components: taxes, contributions to social health insurance, premiums to private health insurance, out of pocket payments by patients. These components can be combined differently leading to specific effects of interpersonal...