Unintended effects of reimbursement schedules in mental health care

Douven, Rudy; Remmerswaal, Minke; Mosca, Ilaria

doi:10.1016/j.jhealeco.2015.03.008

Cited by 18 publications

(19 citation statements)

References 20 publications

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“…Several studies address marginal reimbursement incentives induced by discontinuously increasing prospective payment. Douven et al [18] found that mental health-care providers respond to discontinuously increasing reimbursement schedules by expanding the treatment duration.…”

Section: Discussionmentioning

confidence: 99%

“…Increasing discontinuous reimbursement schedules and their impact on treatment duration and LOS have also been subject to analysis. Douven et al [18] evaluate the introduction of a discontinuous reimbursement schedule for self-employed mental health-care providers in the Netherlands. They find that providers respond to price incentives by treating patients longer to surpass a treatment duration threshold.…”

Section: Introductionmentioning

confidence: 99%

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Do discontinuities in marginal reimbursement affect inpatient psychiatric care in Germany?

Pott¹,

Stargardt²,

Schneider

et al. 2020

Eur J Health Econ

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This paper examines the behaviour of mental health care providers in response to marginal payment incentives induced by a discontinuous per diem reimbursement schedule with varying tariff rates over the length of stay. The analyses use administrative data on 12,627 cases treated in 82 psychiatric hospitals and wards in Germany. We investigate whether substantial reductions in marginal reimbursement per inpatient day led to strategic discharge behaviour once a certain length of stay threshold is exceeded. The data do not show gaps and bunches at the duration of treatment when marginal reimbursement decreases. Using logistic regression models, we find that providers did not react to discontinuities in marginal reimbursement by significantly reducing inpatient length of stay around the threshold. These findings are robust in terms of different model specifications and subsamples. The results indicate that if regulators aim to set incentives to decrease LOS, this might not be achieved by cuts in reimbursement over LOS.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Do discontinuities in marginal reimbursement affect inpatient psychiatric care in Germany?

Pott¹,

Stargardt²,

Schneider

et al. 2020

Eur J Health Econ

View full text Add to dashboard Cite

show abstract

“…The main idea of policy research by Douven et al (2015) is to evaluate the performance-based payment schemes for self-employed mental health-care providers using the large mental health institutions as a control group. Douven et al use administrative data from the Dutch health-care authority covering the years 2008 to 2010.…”

Section: Evaluation Of Performance-based Payment Schemes In Mental Hementioning

confidence: 99%

Data-Driven Policy Impact Evaluation

2019

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“…These large mental health institutions receive an annual budget, and their employees, including psychiatrists, psychologists and mental health-care nurses, receive a fixed salary. The main idea of policy research by Douven et al (2015) is to evaluate the performance-based payment schemes for self-employed mental health-care providers using the large mental health institutions as a control group. Douven et al use administrative data from the Dutch health-care authority covering the years 2008 to 2010.…”

Section: Evaluation Of Performance-based Payment Schemes In Mental Hementioning

confidence: 99%

Microdata and Policy Evaluation at CPB

Douven

Geest

Gerritsen

et al. 2018

Data-Driven Policy Impact Evaluation

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The Activities of CPB Netherlands Bureau for Economic Policy Analysis CPB Netherlands Bureau for Economic Policy Analysis was established in 1945. CPB is the acronym for the Dutch name Centraal Planbureau. CPB is an independent economic think tank, funded by the government, and aims to provide independent, impartial economic analysis that is policy relevant and academically up to standard. CPB's main challenge is to contribute to better economic policies, predominantly through applied empirical research. Theory and good intentions alone are not enough to ensure effective and efficient policy. It is important to establish whether or not these policies will really bear fruit. According to a Dutch saying, 'measurement is the key to knowledge'.

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Unintended effects of reimbursement schedules in mental health care

Cited by 18 publications

References 20 publications

Do discontinuities in marginal reimbursement affect inpatient psychiatric care in Germany?

Do discontinuities in marginal reimbursement affect inpatient psychiatric care in Germany?

Data-Driven Policy Impact Evaluation

Microdata and Policy Evaluation at CPB

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