Value-based provider payment: towards a theoretically preferred design.
Health Econ Policy Law
; 15(1): 94-112, 2020 01.
Article
em En
| MEDLINE
| ID: mdl-30259825
ABSTRACT
Worldwide, policymakers and purchasers are exploring innovative provider payment strategies promoting value in health care, known as value-based payments (VBP). What is meant by 'value', however, is often unclear and the relationship between value and the payment design is not explicated. This paper aims at (1) identifying value dimensions that are ideally stimulated by VBP and (2) constructing a framework of a theoretically preferred VBP design. Based on a synthesis of both theoretical and empirical studies on payment incentives, we conclude that VBP should consist of two components a relatively large base payment that implicitly stimulates value and a relatively small payment that explicitly rewards measurable aspects of value (pay-for-performance). Being the largest component, the base payment design is essential, but often neglected when it comes to VBP reform. We explain that this base payment ideally (1) is paid to a multidisciplinary provider group (2) for a cohesive set of care activities for a predefined population, (3) is fixed, (4) is adjusted for the population's risk profile and (5) includes risk-mitigating measures. Finally, some important trade-offs in the practical operationalisation of VBP are discussed.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Reembolso de Incentivo
/
Reforma dos Serviços de Saúde
Limite:
Humans
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Health Econ Policy Law
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Holanda