OECD Health Policy Studies Better Ways to Pay for Health Care (eBook)

Oecd (Autor)

eBook Download: PDF

2016 | 1. Auflage
168 Seiten
OECD Publishing (Verlag)
978-92-64-25821-1 (ISBN)

Infos

Payers for health care are pursuing a variety of policies as part of broader efforts to improve the quality and efficiency of care.  Payment reform is but one policy tool to improve health system performance that requires supportive measures in place such as policies with well-developed stakeholder involvement, information on quality, clear criteria for tariff setting, and embedding evaluation as part of the policy process. Countries should not, however, underestimate the significant data challenges when looking at price setting processes. Data access and ways to overcome its fragmentation require well-developed infrastructures. Policy efforts highlight a trend towards aligning payer and provider incentives by using evidence-based clinical guidelines and outcomes to inform price setting. There are signs of increasing policy focus on outcomes to inform price setting. These efforts could bring about system-wide effects of using evidence along with a patient-centred focus to improve health care delivery and performance in the long-run.

Inhalt

Foreword 5
Acknowledgements 
6 
Table of contents 7
Acronyms and abbreviations 9
Executive summary 11
Use payment systems to drive strategic objectives in health 12
Design payment innovations 12
Implement payment innovations 12
Evaluate payment innovations 12
Assessment and recommendations 13
Predominant health care provider payment methods in OECD countries have been slow to reform and have often not rewarded value 13
Several countries have innovated provider payment mechanisms to address unwanted incentives of traditional mechanisms 13
Innovative payment reform pursue policy objectives of quality and efficiency 16
Add-on payments for co-ordination can work across different levels of care, but aren ot always linked to cost savings 20
Add-on payments to reward quality have led to quality improvements however it is difficult to separate their impact from those of the other initiatives 21
Bundled payments are used widely and show improved quality, however they require sophisticated IT systems 23
Population-based payments have shown improvements in chronic disease management and preventive care and some savings, however they require a robust technical design 27
Conclusions 31
Notes 34
References 35
Chapter 1. Reforming traditional health care provider payments 39
1.1. Overview 40
1.2. Why reform provider payment? 40
1.3. Traditional provider payment systems and misaligned incentives 42
1.4. The use of blended payment methods across health care settings and recent trends 48
1.5. Adapting traditional payment to ensure it is fit for purpose in contemporary health systems 53
1.6. Innovations in health care provider payments 54
1.7. Conclusion 55
Note 56
References 57
Chapter 2. Add-on health care provider payments 61
2.1. Overview 62
2.2. Using add-on payments to encourage co-ordination 65
2.3. Add-on payments to reward quality and outcomes 69
2.4. Assessment of policy impact of add-on payments 79
2.5. Conditions for the implementation of P4P add-ons across health systems and care settings 84
2.6. Conclusion 95
Notes 97
References 98
Chapter 3. Bundled health care provider payments 103
3.1. Overview 104
3.2. Episode-based payments incentivising best practice or improvement of patient outcomes 104
3.3. Payments are used to improve the quality of care for chronic conditions 110
3.4. Key characteristics of payment reforms towards bundled payments 114
3.5. Assessment of payment reforms 116
3.6. Conditions for implementing payment reform 121
3.7. Building blocks for designing bundled payment 128
3.8. Conclusion 129
Note 132
References 133
Chapter 4. Population-based health care provider payments 137
4.1. Overview 138
4.2. Population-based payment innovations are currently implemented in a variety of countries 139
4.3. Assessment of payment reforms 146
4.4. Conditions for implementing payment reform 149
4.5. Population-based payment and ACO models differ in important technical aspects 152
4.6. Conclusion 160
Notes 163
References 164

Produkt-Details

• Erscheint lt. Verlag: 29.6.2016
• Sprache: englisch
• Themenwelt: Studium ► Querschnittsbereiche ► Prävention / Gesundheitsförderung
• Themenwelt: Sozialwissenschaften ► Pädagogik ► Sozialpädagogik
• Themenwelt: Sozialwissenschaften ► Politik / Verwaltung ► Staat / Verwaltung
• Themenwelt: Sozialwissenschaften ► Soziologie
• ISBN-10: 92-64-25821-3 / 9264258213
• ISBN-13: 978-92-64-25821-1 / 9789264258211