Publicatie

Publicatie datum

Enrollees seem positive about selective contracting by their health insurer.

Bes, R.E., Wendel, S., Jong, J.D. de. Enrollees seem positive about selective contracting by their health insurer. European Journal of Public Health: 2012, 22(suppl. 2) 264. Abstract. 5th European Public Health Conference 'All inclusive public health'. 7-10 November 2012, St. Julians (Malta).
Lees online
Background: In the last decades, health care systems in several European countries changed from a supply-oriented system to a demand-oriented system based on managed competition. In a system of managed competition, health insurers are supposed to prudently purchase care on behalf of their enrollees and channel them to contracted care providers in order to improve health care quality and reduce health care costs. In order to reach these goals, it is crucial that enrollees accept their health insurer’s involvement in their provider choice. The objective of this study is to find out under which conditions enrollees accept this and in how far enrollees already involve their health insurer by asking for information when choosing a care provider. Methods: In December 2012 questionnaires were sent to 7.082 members of the Insurants Panel (response 78%). Respondents were asked about two main aspects: (1) how they feel about their health insurer not contracting care providers that provide insufficient quality and (2) if they want advice from their health insurer when choosing a care provider. Also, respondents who recently visited a hospital or specialist were asked whether or not they consulted their health insurer before choosing a hospital or specialist. Lastly, the influence of respondents’ views on their health insurers’ knowledge about quality of providers and the influence of background characteristics will be analyzed. Results: Most respondents (65%) agree with their health insurer not contracting care providers that provide insufficient quality and also many respondents (41%) want advice from their health insurer. Respondents who are negative about these aspects explain that they would rather choose by themselves and/or that they do not trust their health insurer’s intentions. Very few respondents who recently visited a hospital or specialist, have consulted their health insurer before they chose a care provider. Data are now further analyzed. Conclusion: Preliminary results show that although a lot of enrollees seem positive about their health insurer’s involvement in their provider choice, a small percentage of enrollees actually consult their health insurer.The reason for enrollees to be negative about their health insurers’ involvement seems to be a lack of trust. (aut. ref.)