Das Geschäftsmodell des selektiven Kontrahierens — Eine Analyse wertschöpfender Aktivitäten gesetzlicher Krankenkassen

By establishing Integrated Care sickness funds are introduced the possibilities of signing individual contracts with single or a group of health care providers (selective contracting). So far, this topic has been discussed a lot from the health care system’s point of view. The research presented in this paper however focuses on business aspects from a single sickness fund’s point of view. By selective contracting of providers a sickness fund creates additional value for insurants. Besides the traditional payer function this is especially done by pre-selecting quality-proved providers, stipulating diagnosis and therapy methods, stipulating guarantees and negotiating remunerations. Customer-orientation requires identification of the patient’s different needs and preferences. To satisfy those individually varying demands a sickness fund has to choose carefully its contract partners. A sickness fund’s success depends on the quality of its contracted providers. As selective contracting means that only a chosen number of providers will be contracted, value is created for those by mediating patients with the opportunity of raising both income and utilisation. The value creation by selective contracting can be summarized both for patients as well as for providers as a strong reduction of transaction costs.     

Umsetzungserfahrungen gesetzlicher Krankenkassen mit der Balanced Scorecard: Ein Ergebnisbericht der Gründe,Vorgehensweise und Probleme

The method of the Balanced Scorecard (BSC) is very popular in the management of companies and was recently also adopted by several German statutory sickness funds. For the latter, empirical studies concerning the process of implementation are still missing. The present paper analyses the reasons, approaches and problems of the BSC introduction in statutory sickness funds based on 13 guideline-based expert interviews. In addition, a common model of the BSC implementation is tested. The results show sickness funds specific variations and particularities of the reasons, approaches and problems concerning the implementation of the BSC, but also overlaps with other models and studies are found. The present study can provide a guideline for health insurances and other organisations that are planning to introduce the BSC.     

Betriebswirtschaftliche Forschungsbeiträge zum Management in gesetzlichen Krankenkassen – ein Überblick

This paper reviews all published business research into the management of German statutory health insurance. A comprehensive systematic search of literature was done from 1996 to September 2008. Notably, almost all identified studies were published in health or insurance specific journals or as practical book contributions. In general management journals, research into the health insurance sector is seldom. All investigated management fields of the health insurance are substantially lacking research. Findings from general economic research or research into health insurance in other countries cannot be transferred easily. Therefore research has to adapt concepts from general economic literature or develop new concepts for future studies of the health insurance sector in Germany.     

Der Einfluss von Cat Bonds-Emissionen auf das ökonomische Zielkapital von Schaden-/Unfallversicherungsunternehmen

One of the major problems in the market development of cat bonds is their impact on the economical capital requirement, while non-indemnity-triggers are used. In this article, an example portfolio is constructed which is heavily exposed to hurricane risks in Florida. A cat bond with a parametric trigger, a reinsurance without collateral and two other reference covers are used on this portfolio and their capital relief effect are calculated by means of monte carlo simulation. Amongst others, it shows that not only basis risk, but also default risk and cost disadvantage lead to the decline of a risk transfer instrument's capital relief effect. In the next step, the simulation is extended to the value based management with the capital requirement being a constraint and the maximization of the company's value being the objective function. In this context, the basis risk shows a much lower influence compared with the cost factors.     

Der Einfluss des demographischen Wandels auf die Ausgaben der Krankenversicherung

The analysis presented in this document investigates the question of whether the increase in life expectancy causes financial stress for health insurance systems or not. In particular, the authors focused on the financial impact of the ?costs of dying“ and how much these costs contribute to the total health costs. The article analyses an in-patient and an out-patient tariff of a large private health insurance company in Germany. It is based on health care costs of people who died in 1999 and of those who continued to live. The percentage of the costs of dying is often overestimated. However, the costs of those who continued to live increased overproportionately. In particular, this was true for the insured people over 80 years.The claim that the increase of life expectancy only postpones the high costs in the future and has no impact on the financial conditions of health insurance is doubtful. Older people live longer and have more opportunity to take medication and receive therapy for a longer period. Therefore we argue that longer life expectancy and other factors like progress in medical technology pose a severe threat on the financial stability of health insurance.     

Eignung von Hedgefonds für das Asset Management der deutschen Versicherungsindustrie

Zeitschrift für die gesamte Versicherungswissenschaft - Seit Beginn des Jahres 2004 besteht in Deutschland durch das Investmentmodernisierungsgesetz die Möglichkeit zur Gründung und...     

Empirische Analyse des Einflusses der Überschussbeteiligung auf Neugeschäft und Storno

Recently, German insurers are becoming increasingly interested in assessing and modelling risks related to new business and lapses. The final report of a DAV (German actuarial association) working party on stochastic models for German life insurance companies, released end of 2005, includes some basic approaches for this purpose. However, so far no systematic empirical research has been carried out which provides evidence for an appropriate calibration of such models. This article contributes to closing the gap. It presents the main results of an empirical analysis on the influence of policyholders’ profit participation on new business and lapses based on data about 87 German life insurance companies from 1995—2004. Analyses of regression and correlation were performed for various definitions of the explanatory variable ?profit participation“ (more precisely: the spread to some average value) and with diverse reference parameters for new business and lapses, also considering different types of life insurance. Ultimately, the exploration scarcely yielded evidence for a significant general correlation between policyholders’ profit participation and new business or lapses. However, because of the individuality of life insurance business such an evaluation of historical data can certainly only be regarded as a building block for the overall picture, as is also explained in the paper in some more detail.     

Market Value Margin für die Fair Value-Bilanzierung versicherungstechnischer Verpflichtungen : Ableitung auf Basis des CAPM

The International Accounting Standards Board (IASB) started a project on Insurance Accounting to apply the principles of fair value to insurance businesses. The so called ?asset and liability approach“ would focus on the balance sheet, with both assets and liabilities being reported at fair values, while income and expenses are defined in terms of changes in the values of those assets and liabilities. Indeed, there are no deep and liquid markets for insurance liabilities. Thus, the fair value has to be calculated as a theoretical value, using assumptions concerning future events, risk provisions and discount rates. Both in theory and in practice a generally accepted modelling of fair value is missing. Particularly with regard to the deviation of a Market Value Margin (MVM), which reflects the premium that a marketplace participant would demand for bearing the uncertainty inherent in the cash flows, there is a need for adequate modelling. Transforming the CAPM for determining risk loads in insurance will mean measuring the correlation between insurance companies’ returns from underwriting and market returns on its shareholders’ equity. The criticism on an underwriting beta focuses on (a) the basic assumptions of the CAPM, (b) the absence of active markets for insurance liabilities and (c) the unreliability of estimating underwriting betas.     

Herausforderungen an das Management der Reputation von Versicherungsunternehmen — Ein Bezugsrahmen und Skizzen zu zentralen Gestaltungsansätzen

Especially in the insurance industry, a good corporate reputation is one of the most important strategic success factors, but yet still is a decisive bottleneck. Strong corporate reputations comprise gravitational power and lead in relation to all stakeholder groups (customers, investors, employees, public etc) to relevant supportive behaviours. However, to build up, maintain, and benefit from corporate reputations strategically, a comprehensive management approach which influences the whole corporate development is a key requirement. Without normative and strategic management such an attempt is without orientation, and without operative management and well-suited intelligence, implementation, and controlling systems without power. According to the need of a comprehensive concept for managing corporate reputations efficiently and effectively, this contribution sketches a basic framework of integrated corporate reputation management, and provides some thought provoking ideas concerning the development of such a concept in robust steps. Anyway, this contribution should make clear that the management of corporate reputation has not much to do with superficial image campaigns.     

Der Einfluss des Versicherungskapitalanlagen-Bewertungsgesetzes (VersKapAG) auf Überschüsse und Überschussbeteiligung in der Lebensversicherung — Eine empirische Untersuchung —

On March 26, 2002 the valuation rules for securities of German insurance companies were amended. From the reporting year ending later than September 29, 2001, firms no longer need to apply the strict rules of short-term investment securities. If assets are classified as held-to-maturity or available-for-sale, temporary impairments need not be recognised in the profit and loss accounts. The legislator wanted to create a level playing field for financial institutions as similar rules were already applicable to banks. As an effect with-profits policies were expected to show a more stable pattern of profit sharing. Analysing data from 1998 to 2003 for German life insurers, no different picture of surplus-sharing emerges. This may be due to the fact that valuation rules are only one mechanism of surplus sharing, and other mechanisms that were well established already serve the insurance industry well enough to compete with other providers of financial products.