Risk adjustment in Switzerland

被引：26

作者：

Beck, K

Spycher, S

Holly, A

Gardiol, L

机构：

[1] CSS Insurance, Dept Stat, CH-6002 Luzern, Switzerland

[2] Univ Lausanne, IEMS, Lausanne, Switzerland

来源：

HEALTH POLICY | 2003年 / 65卷 / 01期

关键词：

risk adjustment; sickness fund; health insurance; consumer mobility; health care financing; cost containment;

D O I：

10.1016/S0168-8510(02)00117-3

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

In Switzerland the new law on Health Insurance, effective since 1996, introduced pro competitive changes in the market of sickness funds. The legislator expected high mobility between sickness funds of both healthy and sick insured as open enrolment was introduced with the new law. That is why the risk adjustment scheme, that was already introduced 1993, was limited until 2005. However, consumer mobility remained low and risk selection strategies are still profitable, since risk-adjustment is based only on demographic variables. This paper describes risk adjustment, consumer mobility, risk selection activities of sickness funds and the impact of imperfect risk adjustment on the development of HMO and PPO models. The paper concludes with a description of the current political and scientific discussion in Switzerland. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.

引用

页码：63 / 74

页数：12