Seminar: Insurance reforms and provider fees
The Centre for Health Economics (CHE) is hosting the seminar, ‘Insurance reforms and provider fees: Evidence from an Australian experiment’, with insights from Associate Professor Kees van Gool from the University of Technology Sydney.
Around one million Australians qualify for the Extended Medicare Safety Net (EMSN) each year. The EMSN pays 80% of the fee charged by doctors for out-of-hospital services funded by Medicare once a family reaches a threshold in out-of-pocket costs. Its design is akin to 'donut hole' insurance. In this seminar we draw on recent papers that examine two separate reforms to the EMSN implemented in 2010 and 2015. Both papers use the Sax Institute's 45 and Up study of 260,000 residents living in NSW and is linked to administrative data that provides us with an accurate picture of fees charged by providers before and after the EMSN reforms.
Paper 1: Provider responses to insurance benefit restrictions: the case of ophthalmology
Paper 2: Physician pricing behaviour: the case of a patient eligibility restriction
Authors: Olukorede Abiona, Serena Yu, Phil Haywood, Jane Hall, Denzil G. Fiebig and Kees van Gool
Kees van Gool is a Deputy Director and Associate Professor at the Centre. He has extensive experience in international, national and regional health policy research. He is CI on an ARC Discovery Project looking at the impact of the Medicare Safety Net reforms on provider and patient behaviours. He is the lead investigator on a recently awarded NHMRC Centre for Research Excellence on value-based funding in cancer care. He was a chief investigator for the Centre for Research Excellence on the Financing and Economics of Primary Care (REFinE), funded by the Australian Primary Care Institute (APHCRI). He has worked extensively on cancer care, screening, cystic fibrosis and policy evaluation. He is an applied economist and has established a track record in using linked data in for policy evaluation. In 2011 he completed his PhD at the University of Technology Sydney, looking at the out-of-pocket costs faced by patients under Australia's Medicare system. Kees has previously worked at the Department of Health, NSW Health and OECD where he led a project on international health system performance and policy analysis on cardiovascular disease care and outcomes.
Visitors are welcome to attend – registration is not required.
We hope to see you there.
Event Details
- Date:
- 23 October 2019 at 12:00 pm – 1:00 pm
- Venue:
- Monash University Caulfield campus, Building H, Level 9, Seminar room H9.21
- Categories:
- Health Economics
Description
The Centre for Health Economics (CHE) is hosting the seminar, ‘Insurance reforms and provider fees: Evidence from an Australian experiment’, with insights from Associate Professor Kees van Gool from the University of Technology Sydney.
Around one million Australians qualify for the Extended Medicare Safety Net (EMSN) each year. The EMSN pays 80% of the fee charged by doctors for out-of-hospital services funded by Medicare once a family reaches a threshold in out-of-pocket costs. Its design is akin to 'donut hole' insurance. In this seminar we draw on recent papers that examine two separate reforms to the EMSN implemented in 2010 and 2015. Both papers use the Sax Institute's 45 and Up study of 260,000 residents living in NSW and is linked to administrative data that provides us with an accurate picture of fees charged by providers before and after the EMSN reforms.
Paper 1: Provider responses to insurance benefit restrictions: the case of ophthalmology
Paper 2: Physician pricing behaviour: the case of a patient eligibility restriction
Authors: Olukorede Abiona, Serena Yu, Phil Haywood, Jane Hall, Denzil G. Fiebig and Kees van Gool
Kees van Gool is a Deputy Director and Associate Professor at the Centre. He has extensive experience in international, national and regional health policy research. He is CI on an ARC Discovery Project looking at the impact of the Medicare Safety Net reforms on provider and patient behaviours. He is the lead investigator on a recently awarded NHMRC Centre for Research Excellence on value-based funding in cancer care. He was a chief investigator for the Centre for Research Excellence on the Financing and Economics of Primary Care (REFinE), funded by the Australian Primary Care Institute (APHCRI). He has worked extensively on cancer care, screening, cystic fibrosis and policy evaluation. He is an applied economist and has established a track record in using linked data in for policy evaluation. In 2011 he completed his PhD at the University of Technology Sydney, looking at the out-of-pocket costs faced by patients under Australia's Medicare system. Kees has previously worked at the Department of Health, NSW Health and OECD where he led a project on international health system performance and policy analysis on cardiovascular disease care and outcomes.
Visitors are welcome to attend – registration is not required.
We hope to see you there.
Event Contact
- Name
- che-enquiries@monash.edu
- Phone
- Organisation