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Risk-adjusted funding of health insurers in The Netherlands Seminar on Risk-adjusted funding and equalization PowerPoint Presentation
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Risk-adjusted funding of health insurers in The Netherlands Seminar on Risk-adjusted funding and equalization. Jan Bultman Lead Health Specialist World Bank Moscow December 20, 2004. Conditions. Sharply defined health benefits package Functioning complaints/grievance procedures

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slide1

Risk-adjusted funding of health insurers in The NetherlandsSeminar on Risk-adjusted funding and equalization

Jan Bultman

Lead Health Specialist

World Bank

Moscow December 20, 2004

conditions
Conditions
  • Sharply defined health benefits package
  • Functioning complaints/grievance procedures
  • Consensus about health care delivery
  • Competing insurers and functioning anti-cartel agency
  • No risk-adjusted contributions
  • Acceptance of every insured, regardless of health
  • Adequate administration (incl. data collection and transfer
  • Sophisticated health management information system
conditions ii
Conditions II
  • Adequate privacy protection of insured
  • Adequate protection of sensitive insurers data
  • Adequate insight in expenditures/insured
  • Adequate administration of insured
  • Functioning oversight/audit system
  • Reliable and transparent process
  • All actors act as agreed
  • Regular adjustment of parameter values
slide4
Variation in total expenditures per insured for 21 SF’s in percentage of the average expenditures for all SF’s in ’98 and in ‘03