Table 2.
Average under- and overcompensation per person in year t for selected groups based on information from year t − 1, using the Dutch risk equalization formula-2014
| Selected groups based on information from year t − 1 | Estimated percentage of population | Undercompensation (−) in year t | Predictive ratio* in year t | Reduction of undercompensation compared with no risk equalization |
|---|---|---|---|---|
| Worst score physical health (SF-12) | 18.9 % | −€670 | 0.85 | –75 % |
| Contact with a medical specialist in the last 12 months | 37.8 % | −€326 | 0.90 | –75 % |
| Use of physiotherapy in the last 12 months | 21.8 % | −€328 | 0.89 | –71 % |
| At least one chronic condition | 31.5 % | −€331 | 0.90 | –80 % |
| Selected groups based on information from year t − 1 | Estimated percentage of population | Overcompensation (+) in year t | Predictive ratio* in year t | Reduction of overcompensation compared with no risk equalization |
|---|---|---|---|---|
| No chronic condition | 68.5 % | +€152 | 1.16 | –66 % |
| Best score physical health (SF-12) | 19.2 % | +€291 | 1.31 | –71 % |
| No health care utilization in the last 12 months | 19.5 % | +€298 | 1.51 | –75 % |
| Highest education levels | 22.8 % | +€142 | 1.10 | –61 % |
Because the Dutch government requires a community rating per health plan, for each selected group the average under- and overcompensation per person has been calculated as the average residual expenses per person. All presented under- and overcompensations are statistically significant at the 0.01 level, except for “highest education levels”, which are statistically significant at the 0.05 level
The Dutch risk equalization model of 2014 is based on the following risk characteristics, which over time have been added successively: age interacted with gender (1993), region (1995), source of income interacted with age (1999), pharmacy-based cost groups (2002), diagnoses-based cost groups (2004), socioeconomic status interacted with age (2008), multiple-year high costs (2012), yes/no student, and prior use of durable-medical-equipment (2014)
* The predictive ratio equals the ratio of the average predicted expenses and the average actual expenses of the individuals in the selected group