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Balancing financial incentives during COVID-19: A comparison of provider payment adjustments across 20 countries
R. Waitzberg, S. Gerkens, A. Dimova, L. Bryndová, K. Vrangbæk, SS. Jervelund, HO. Birk, S. Rajan, T. Habicht, LK. Tynkkynen, I. Keskimäki, Z. Or, C. Gandré, J. Winkelmann, W. Ricciardi, AG. de Belvis, A. Poscia, A. Morsella, A. Slapšinskaitė, L....
Jazyk angličtina Země Irsko
Typ dokumentu časopisecké články, přehledy
Grantová podpora
001
World Health Organization - International
- MeSH
- COVID-19 * MeSH
- lidé MeSH
- motivace MeSH
- pandemie MeSH
- poplatky a výdaje MeSH
- rozpočty MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Provider payment mechanisms were adjusted in many countries in response to the COVID-19 pandemic in 2020. Our objective was to review adjustments for hospitals and healthcare professionals across 20 countries. We developed an analytical framework distinguishing between payment adjustments compensating income loss and those covering extra costs related to COVID-19. Information was extracted from the Covid-19 Health System Response Monitor (HSRM) and classified according to the framework. We found that income loss was not a problem in countries where professionals were paid by salary or capitation and hospitals received global budgets. In countries where payment was based on activity, income loss was compensated through budgets and higher fees. New FFS payments were introduced to incentivize remote services. Payments for COVID-19 related costs included new fees for out- and inpatient services but also new PD and DRG tariffs for hospitals. Budgets covered the costs of adjusting wards, creating new (ICU) beds, and hiring staff. We conclude that public payers assumed most of the COVID-19-related financial risk. In view of future pandemics policymakers should work to increase resilience of payment systems by: (1) having systems in place to rapidly adjust payment systems; (2) being aware of the economic incentives created by these adjustments such as cost-containment or increasing the number of patients or services, that can result in unintended consequences such as risk selection or overprovision of care; and (3) periodically evaluating the effects of payment adjustments on access and quality of care.
Belgian Health Care Knowledge Centre Belgium
Center for Social and Economic Strategies Faculty of Social Science Charles University Czechia
Data Sciences for Health Services and Policy Research Institute for Health Sciences in Aragon Spain
European Observatory on Health Systems and Policies Belgium
Faculty of Public Health Medical University Varna Bulgaria
Finnish Institute for Health and Welfare and Tampere University Faculty of Social Sciences Finland
Institute for Research and Information in Health Economics France
London School of Hygiene and Tropical Medicine London UK
National School of Public Health Management and Professional Development Bucharest Romania
Netherlands Institute of Health Services Research Utrecht the Netherlands
Swedish Agency for Health and Care Services Analysis
Tampere University Faculty of Social Sciences Finland
The Smokler Center for Health Policy Research Myers JDC Brookdale Institute Jerusalem Israel
University of Lucerne Department of Health Sciences and Medicine Switzerland
Citace poskytuje Crossref.org
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- $a Waitzberg, Ruth $u Department of Health Care Management, Faculty of Economics & Management, Technische Universität Berlin, Germany; The Smokler Center for Health Policy Research, Myers-JDC-Brookdale Institute, Jerusalem, Israel. Electronic address: Ruth.waitzberg@tu-berlin.de
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- $a Balancing financial incentives during COVID-19: A comparison of provider payment adjustments across 20 countries / $c R. Waitzberg, S. Gerkens, A. Dimova, L. Bryndová, K. Vrangbæk, SS. Jervelund, HO. Birk, S. Rajan, T. Habicht, LK. Tynkkynen, I. Keskimäki, Z. Or, C. Gandré, J. Winkelmann, W. Ricciardi, AG. de Belvis, A. Poscia, A. Morsella, A. Slapšinskaitė, L. Miščikienė, M. Kroneman, J. de Jong, M. Tambor, C. Sowada, SG. Scintee, C. Vladescu, T. Albreht, E. Bernal-Delgado, E. Angulo-Pueyo, F. Estupiñán-Romero, N. Janlöv, S. Mantwill, E. Van Ginneken, W. Quentin
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- $a Provider payment mechanisms were adjusted in many countries in response to the COVID-19 pandemic in 2020. Our objective was to review adjustments for hospitals and healthcare professionals across 20 countries. We developed an analytical framework distinguishing between payment adjustments compensating income loss and those covering extra costs related to COVID-19. Information was extracted from the Covid-19 Health System Response Monitor (HSRM) and classified according to the framework. We found that income loss was not a problem in countries where professionals were paid by salary or capitation and hospitals received global budgets. In countries where payment was based on activity, income loss was compensated through budgets and higher fees. New FFS payments were introduced to incentivize remote services. Payments for COVID-19 related costs included new fees for out- and inpatient services but also new PD and DRG tariffs for hospitals. Budgets covered the costs of adjusting wards, creating new (ICU) beds, and hiring staff. We conclude that public payers assumed most of the COVID-19-related financial risk. In view of future pandemics policymakers should work to increase resilience of payment systems by: (1) having systems in place to rapidly adjust payment systems; (2) being aware of the economic incentives created by these adjustments such as cost-containment or increasing the number of patients or services, that can result in unintended consequences such as risk selection or overprovision of care; and (3) periodically evaluating the effects of payment adjustments on access and quality of care.
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- $a Gerkens, Sophie $u Belgian Health Care Knowledge Centre, Belgium. Electronic address: Sophie.Gerkens@kce.fgov.be
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- $a Dimova, Antoniya $u Faculty of Public Health, Medical University - Varna, Bulgaria. Electronic address: ant_dimova@abv.bg
- 700 1_
- $a Bryndová, Lucie $u Center for Social and Economic Strategies, Faculty of Social Science, Charles University, Czechia. Electronic address: lucie.bryndova@fsv.cuni.cz
- 700 1_
- $a Vrangbæk, Karsten $u University of Copenhagen, Department of Public Health, Section for Health Services Research, Copenhagen, Denmark. Electronic address: kv@ifs.ku.dk
- 700 1_
- $a Jervelund, Signe Smith $u University of Copenhagen, Department of Public Health, Section for Health Services Research, Copenhagen, Denmark. Electronic address: ssj@sund.ku.dk
- 700 1_
- $a Birk, Hans Okkels $u University of Copenhagen, Department of Public Health, Section for Health Services Research, Copenhagen, Denmark. Electronic address: hob@sund.ku.dk
- 700 1_
- $a Rajan, Selina $u London School of Hygiene and Tropical Medicine, London, UK. Electronic address: Selina.Rajan@lshtm.ac.uk
- 700 1_
- $a Habicht, Triin $u WHO Barcelona Office for Health Systems Financing, Spain. Electronic address: habichtt@who.int
- 700 1_
- $a Tynkkynen, Liina-Kaisa $u Tampere University, Faculty of Social Sciences, Finland. Electronic address: liina-kaisa.tynkkynen@tuni.fi
- 700 1_
- $a Keskimäki, Ilmo $u Finnish Institute for Health and Welfare and Tampere University, Faculty of Social Sciences, Finland
- 700 1_
- $a Or, Zeynep $u Institute for Research and Information in Health Economics, France. Electronic address: or@irdes.fr
- 700 1_
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- 700 1_
- $a Winkelmann, Juliane $u Department of Health Care Management, Faculty of Economics & Management, Technische Universität Berlin, Germany. Electronic address: Juliane.winkelmann@tu-berlin.de
- 700 1_
- $a Ricciardi, Walter $u Section of Hygiene, University Department of Life Sciences and Public Health-Università Cattolica del Sacro Cuore, Italy. Electronic address: Walter.ricciardi@unicatt.it
- 700 1_
- $a de Belvis, Antonio Giulio $u Section of Hygiene, University Department of Life Sciences and Public Health-Università Cattolica del Sacro Cuore, Italy. Electronic address: Antonio.debelvis@unicatt.it
- 700 1_
- $a Poscia, Andrea $u UOC ISP Prevention and Surveillance of Infectious and Chronic Diseases-Department of Prevention-Local Health Authority (ASUR-AV2), Jesi, Italy. Electronic address: Andrea.poscia@sanita.marche.it
- 700 1_
- $a Morsella, Alisha $u Section of Hygiene, University Department of Life Sciences and Public Health-Università Cattolica del Sacro Cuore, Italy. Electronic address: Alisha.morsella@unicatt.it
- 700 1_
- $a Slapšinskaitė, Agnė $u Faculty of Public Health, Health Research Institute, Medical Academy, Lithuanian University of Health Sciences, Lithuania. Electronic address: agne.slapsinskaite@lsmuni.lt
- 700 1_
- $a Miščikienė, Laura $u Faculty of Public Health, Health Research Institute, Medical Academy, Lithuanian University of Health Sciences, Lithuania. Electronic address: Laura.Miscikiene@lsmuni.lt
- 700 1_
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- 700 1_
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- 700 1_
- $a Tambor, Marzena $u Department of Health Economics and Social Security, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Cracow, Poland. Electronic address: marzena.tambor@uj.edu.pl
- 700 1_
- $a Sowada, Christoph $u Department of Health Economics and Social Security, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Cracow, Poland. Electronic address: christoph.sowada@uj.edu.pl
- 700 1_
- $a Scintee, Silvia Gabriela $u National School of Public Health, Management and Professional Development Bucharest, Romania. Electronic address: sscintee@snspms.ro
- 700 1_
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- 700 1_
- $a Albreht, Tit $u National Institute of Public Health of Slovenia, Department of Public Health, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia. Electronic address: tit.albreht@nijz.si
- 700 1_
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- 700 1_
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- 700 1_
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- 700 1_
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- 700 1_
- $a Quentin, Wilm $u Department of Health Care Management, Faculty of Economics & Management, Technische Universität Berlin, Germany; European Observatory on Health Systems and Policies, Belgium. Electronic address: wilm.quentin@tu-berlin.de
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