A typology for provider payment systems in health care

A typology to classify provider payment systems from an incentive point of view is developed. We analyse the way, how these systems can influence provider behaviour and, a fortiori, contribute to attain the general objectives of health care, i.e. quality of care, efficiency and accessibility. The fi...

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Vydané v:Health policy (Amsterdam) Ročník 60; číslo 3; s. 255 - 273
Hlavní autori: Jegers, Marc, Kesteloot, Katrien, De Graeve, Diana, Gilles, Willem
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: Ireland Elsevier Ireland Ltd 01.06.2002
Elsevier
Edícia:Health Policy
Predmet:
Belgium
GP reimbursement
Health Care Costs
Hospital reimbursement
Insurance, Hospitalization
Insurance, Physician Services
National Health Programs - economics
Prospective payment
Provider payment
Reimbursement Mechanisms - classification
Reimbursement, Incentive - classification
Retrospective payment
Belgium
Retrospective payment
GP reimbursement
Hospital reimbursement
Provider payment
Prospective payment
ISSN:0168-8510, 1872-6054
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Shrnutí:A typology to classify provider payment systems from an incentive point of view is developed. We analyse the way, how these systems can influence provider behaviour and, a fortiori, contribute to attain the general objectives of health care, i.e. quality of care, efficiency and accessibility. The first dimension of the typology indicates whether there is a link between the provider's income and his activity. In variable systems, the provider has an ability to influence his earnings, contrary to fixed systems. The second dimension indicates whether the provider's payments are related to his actual costs or not. In retrospective systems, the provider's own costs are the basis for reimbursement ex post whereas in prospective systems payments are determined ex ante without any link to the real costs of the individual provider. These different characteristics are likely to influence provider behaviour in different ways. Furthermore the most frequently used criteria to determine the provider's income are discussed: per service, per diem, per case, per patient and per period. Also a distinction is made between incentives at the level of the individual provider (micro-level) and the sponsor (macro-level). Finally, the potential interactions when several payment systems are used simultaneously are discussed. This typology is useful to classify and compare different types of payment systems as prevailing in different countries, and provides a useful framework for future research of health care payment systems.
Bibliografia:ObjectType-Article-2
SourceType-Scholarly Journals-1
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content type line 23
ISSN:0168-8510
1872-6054
DOI:10.1016/S0168-8510(01)00216-0