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The European Journal of Public Health 2001 11(2):182-184; doi:10.1093/eurpub/11.2.182
© 2001 by European Journal of Public Health
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RISK ADJUSTMENT IN SOCIAL INSURANCE SYSTEMS

Risk-adjusted capitation: the Israeli experience

AMIR SHMUELI1,2 and DAVID CHINITZ1

1The Hebrew University School of Public Health Jerusalem, Israel
2The Gertner Institute for Health Policy Research Hashomer, Israel

Correspondence: Amir Shmueli, Ph.D, Department of Health Management, The Hebrew University School of Public Health, POB 12272, Jerusalem 91120, Israel, ashmueli{at}md2.huji.ac.il

As in a number of countries during the 1990s, Israel’s health system has been undergoing structural reform based on public contracting and regulated markets. The main element of the reform was the enactment of the National Health Insurance Law (NHI), which went into effect on 1 January 1995. According to the Law, the sick funds receive risk-adjusted capitation payments, which place them fully at risk for the cost of supplying a legally mandated basket of health benefits. The paper analyses the effects of the NHI on the Israeli competitive health insurance market and discusses the major policy issues facing the Israeli system.

Keywords: capitation, Israel, National Insurance, risk adjustment


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