Richard C van Kleef
Biographic Data
| ID | 5541275 |
|---|---|
| NAME | Richard C van Kleef |
| GIVEN NAMES | Richard C |
| FAMILY NAME | van Kleef |
| SIGNATURE | VAN KLEEF R C |
| AFFILIATIONS | Erasmus University Rotterdam |
| ORCID | 0000-0002-8971-6341 |
| VERIFIED | Yes |
| TOTAL WORKS | 8 |
| TOTAL CITATIONS | 0 |
| AUTHOR COUNT | 8 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2010 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 0 |
Policy innovation in voluntary hospital private health insurance
BACKGROUND: Australia's voluntary hospital Private Health Insurance (PHI) uses community-rated premiums to enhance fairness and accessibility. However, community rating results in predictable profits on young, healthy people and predictable losses on the elderly and chronically ill, creating incentives for insurers to engage in risk selection. To address this, a risk equalisation scheme is applied. OBJECTIVE: This paper evaluates the effectivenes…
Can risk-rating of incremental premiums improve consumer sorting across coverage options in mandatory health insurance markets
Risk Adjustment in Health Insurance Markets
OBJECTIVES: The goals of this paper are: (1) to identify groups of healthy people; and (2) to quantify the extent to which the Dutch risk adjustment (RA) model overpays insurers for these groups. BACKGROUND: There have been strong signals that insurers in the Dutch regulated health insurance market engage in actions to attract healthy people. A potential explanation for this behavior is that the Dutch RA model overpays insurers for healthy people…
Predictable profits and losses in a health insurance market with risk equalization
Diagnosis-based Cost Groups in the Dutch Risk-equalization Model
BACKGROUND: The risk-equalization (RE) model in the Dutch health insurance market has evolved to a sophisticated model containing direct proxies for health. However, it still has important imperfections, leaving incentives for risk selection. This paper focuses on refining an important health-based risk-adjuster in this model: the diagnosis-based costs groups (DCGs). The current (2017) DCGs are calibrated on "old" data of 2011/2012, are mutually …
Improving Risk Equalization Using Multiple-year High Cost as a Health Indicator
BACKGROUND: More and more competitive health insurance markets use risk equalization to compensate health plans for the predictable high costs of chronically ill enrollees. In the presence of premium rate restrictions, an important goal of risk equalization is to reduce incentives for selection, while maintaining incentives for efficiency. The literature shows, however, that even the most sophisticated risk equalization models--which include both…
Risk-Adjusting the Doughnut Hole to Improve Efficiency and Equity
An important goal of consumer cost-sharing in health insurance is to increase incentives for cost containment. A relatively new cost-sharing phenomenon is the "doughnut hole": a gap in coverage starting at a predefined level of medical expenses. An important question is where to locate the starting point to achieve the strongest incentives for cost containment. We argue that the answer depends on an individual's health status. Using data from a D…
Prior Use of Durable Medical Equipment as a Risk Adjuster for Health-Based Capitation
This paper examines a new risk adjuster for capitation payments to Dutch health plans, based on the prior use of durable medical equipment (DME). The essence is to classify users of DME in a previous year into clinically homogeneous classes and to apply the resulting classification as a risk adjuster for capitation payments in the subsequent year. We evaluate 143 DME types in terms of incentives, validity, predictive value, and measurability, res…
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Prior Use of Durable Medical Equipment as a Risk Adjuster for Health-Based Capitation
This paper examines a new risk adjuster for capitation payments to Dutch health plans, based on the prior use of durable medical equipment (DME). The essence is to classify users of DME in a previous year into clinically homogeneous classes and to apply the resulting classification as a risk adjuster for capitation payments in the subsequent year. We evaluate 143 DME types in terms of incentives, validity, predictive value, and measurability, res…
Risk-Adjusting the Doughnut Hole to Improve Efficiency and Equity
An important goal of consumer cost-sharing in health insurance is to increase incentives for cost containment. A relatively new cost-sharing phenomenon is the "doughnut hole": a gap in coverage starting at a predefined level of medical expenses. An important question is where to locate the starting point to achieve the strongest incentives for cost containment. We argue that the answer depends on an individual's health status. Using data from a D…
Improving Risk Equalization Using Multiple-year High Cost as a Health Indicator
BACKGROUND: More and more competitive health insurance markets use risk equalization to compensate health plans for the predictable high costs of chronically ill enrollees. In the presence of premium rate restrictions, an important goal of risk equalization is to reduce incentives for selection, while maintaining incentives for efficiency. The literature shows, however, that even the most sophisticated risk equalization models--which include both…
Diagnosis-based Cost Groups in the Dutch Risk-equalization Model
BACKGROUND: The risk-equalization (RE) model in the Dutch health insurance market has evolved to a sophisticated model containing direct proxies for health. However, it still has important imperfections, leaving incentives for risk selection. This paper focuses on refining an important health-based risk-adjuster in this model: the diagnosis-based costs groups (DCGs). The current (2017) DCGs are calibrated on "old" data of 2011/2012, are mutually …
Predictable profits and losses in a health insurance market with risk equalization
Risk Adjustment in Health Insurance Markets
OBJECTIVES: The goals of this paper are: (1) to identify groups of healthy people; and (2) to quantify the extent to which the Dutch risk adjustment (RA) model overpays insurers for these groups. BACKGROUND: There have been strong signals that insurers in the Dutch regulated health insurance market engage in actions to attract healthy people. A potential explanation for this behavior is that the Dutch RA model overpays insurers for healthy people…
Policy innovation in voluntary hospital private health insurance
BACKGROUND: Australia's voluntary hospital Private Health Insurance (PHI) uses community-rated premiums to enhance fairness and accessibility. However, community rating results in predictable profits on young, healthy people and predictable losses on the elderly and chronically ill, creating incentives for insurers to engage in risk selection. To address this, a risk equalisation scheme is applied. OBJECTIVE: This paper evaluates the effectivenes…
Can risk-rating of incremental premiums improve consumer sorting across coverage options in mandatory health insurance markets
Healthcare Policy and Management (7 works) · Actuarial science (6 works) · Business (6 works) · Medicine (6 works) · Economics (5 works) · Incentive (5 works) · Computer Science (4 works) · Healthcare Systems and Reforms (4 works) · Microeconomics (4 works) · Finance (3 works)