Haemophilia in the German risk adjustment scheme

Haemophilia presents a challenge to every risk adjustment scheme even if it uses diagnostical or pharmaceutical data. The German adjustment scheme developed by the Bundesversicherungsamt realizes fairly cost homogenous groups for many expensive diseases. It does not regard haemophilia. This holds tr...

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Bibliographic Details
Published inHämostaseologie Vol. 30 Suppl 1; p. S65
Main Author Ballesteros, P
Format Journal Article
LanguageGerman
Published Germany 01.11.2010
Subjects
Germany
Hemophilia A - classification
Hemophilia A - economics
Humans
National Health Programs - economics
Risk Adjustment - economics
Risk Adjustment - methods
Risk Assessment
Germany
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Summary:Haemophilia presents a challenge to every risk adjustment scheme even if it uses diagnostical or pharmaceutical data. The German adjustment scheme developed by the Bundesversicherungsamt realizes fairly cost homogenous groups for many expensive diseases. It does not regard haemophilia. This holds true for the original classification system (grouper) from 2009 and for the improved classification procedure in 2010. The extreme peak costs that can originate from haemophilia cases can present a existential risk for small health plans. The chances to form cost-homogeneous subgroups of the haemophilia disease by more specific coding or other measures seem low because of the small number of cases affected by this disease. The complementary (re-)installation of a expenditure-oriented risk sharing is regarded as suited for improvement of the performance of the German risk adjustment scheme. This also corresponds to international experience and practice.
ISSN:0720-9355