New Health Insurance Study Results from S. Bauhoff et al Described (Plan responses to diagnosis-based payment: Evidence from Germany’s…

Managed Care Weekly Digest

New Health Insurance Study Results from S. Bauhoff et al Described (Plan responses to diagnosis-based payment: Evidence from Germany's morbidity-based risk adjustment)

By a News Reporter-Staff News Editor at Managed Care Weekly Digest -- Researchers detail new data in Health Insurance. According to news reporting from Washington, District of Columbia, by NewsRx journalists, research stated, "Many competitive health insurance markets adjust payments to participating health plans according to their enrollees' risk - including based on diagnostic information. We investigate responses of German health plans to the introduction of morbidity-based risk adjustment in the Statutory Health Insurance in 2009, which triggers payments based on 'validated' diagnoses by providers."

The news correspondents obtained a quote from the research, "Using the regulator's data from office-based physicians, we estimate a difference-in-difference analysis of the change in the share and number of validated diagnoses for ICD codes that are inside or outside the risk adjustment but are otherwise similar. We find a differential increase in the share of validated diagnoses of 2.6 and 3.6 percentage points (3-4%) between 2008 and 2013. This increase appears to originate from both a shift from not-validated toward validated diagnoses and an increase in the number of such diagnoses."

According to the news reporters, the research concluded: "Overall, our results indicate that plans were successful in influencing physicians' coding practices in a way that could lead to higher payments."

For more information on this research see: Plan responses to diagnosis-based payment: Evidence from Germany's morbidity-based risk adjustment. Journal of Health Economics, 2017;56():397-413. Journal of Health Economics can be contacted at: Elsevier Science Bv, PO Box 211, 1000 Ae Amsterdam, Netherlands. (Elsevier - www.elsevier.com; Journal of Health Economics - www.journals.elsevier.com/journal-of-health-economics/)

Our news journalists report that additional information may be obtained by contacting S. Bauhoff, Center Global Dev, Washington, DC 20036, United States. Additional authors for this research include L. Fischer, D. Gopffarth and A.C. Wuppermann (see also Health Insurance).

Keywords for this news article include: Washington, District of Columbia, United States, North and Central America, Health and Medicine, Health Insurance.