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Strategic cost-shifting in long-term care. Evidence from the Netherlands

Peter Alders,Frederik T Schut

Health Policy（2022）

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Abstract
•With the 2015 Dutch LTC reforms, social LTC was delegated to municipalities.•Municipalities have financial incentives to shift costs to public LTC insurance.•Low solvency and tightening budgets result in strategic cost-shifting by municipalities.•By improving incentives and reducing overlapping entitlements cost-shifting can be counteracted.
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Key words
Long-term care,Decentralization,Financial incentives,Municipalities,Cost-shifting
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