Risk equalization in competitive health insurance markets: Identifying healthy individuals on the basis of multiple-year low spending

Objective: To study the extent to which risk equalization (RE) in competitive health insurance markets can be improved by including an indicator for being healthy. Study Setting/Data Sources: This study is conducted in the context of the Dutch individual health insurance market. Administrative data on spending and risk characteristics (2011-2014) for the entire population (N = 16.6 m) as well as health survey data from a large sample (N = 387 k) are used. Study Design: The indicator for being healthy is low spending in thr