Performance of reimbursement schemes in valuation of technologies: the example of magnetic resonance imaging.

Different reimbursement schemes for health care providers have been developed worldwide. They have evolved over time and have been influenced by politics, costs, patient needs and technological progress. Different methods in the valuation of technologies and their reflection in outpatient reimbursement schemes are analyzed. Using Magnetic Resonance Imaging (MRI) as an example, five different reimbursement schemes from four countries are compared according to defined performance criteria. Major differences in the structure and valuation of internationally used reimbursement schemes are presented; Prices for Neurocranium MRI scans vary from euro98 to euro462 and large discrepancies can even be found within the same country. There are politically driven reimbursement schemes like the German Gebührenordnung für 'A'rzte, while others such as the Swiss TARMED are primarily based on actual costs.