Do Capitation‐based Reimbursement Systems Underfund Tertiary Healthcare Providers? Evidence from New Zealand

B-Tier
Journal: Health Economics
Year: 2017
Volume: 26
Issue: 12
Pages: e81-e102

Authors (3)

Somi Shin (not in RePEc) Christoph Schumacher (not in RePEc) Eberhard Feess (Victoria University of Welling...)

Score contribution per author:

0.670 = (α=2.01 / 3 authors) × 1.0x B-tier

α: calibrated so average coauthorship-adjusted count equals average raw count

Abstract

One of the main concerns about capitation‐based reimbursement systems is that tertiary institutions may be underfunded due to insufficient reimbursements of more complicated cases. We test this hypothesis with a data set from New Zealand that, in 2003, introduced a capitation system where public healthcare provider funding is primarily based on the characteristics of the regional population. Investigating the funding for all cases from 2003 to 2011, we find evidence that tertiary providers are at a disadvantage compared with secondary providers. The reasons are that tertiary providers not only attract the most complicated, but also the highest number of cases. Our findings suggest that accurate risk adjustment is crucial to the success of a capitation‐based reimbursement system. Copyright © 2017 John Wiley & Sons, Ltd.

Technical Details

RePEc Handle
repec:wly:hlthec:v:26:y:2017:i:12:p:e81-e102
Journal Field
Health
Author Count
3
Added to Database
2026-01-25