ABSTRACT
When observing countries' responses to COVID-19, conclusions can be drawn on the modalities, successes, failures and governance challenges of partnerships between the public and private sectors during the pandemic. In the United Kingdom, Israel and Austria, these partnerships have contributed substantially to the overall emergency response, albeit with gaps and weaknesses in their structures and processes. These have differed from those of typical public-private partnerships. To be sustainable, partnerships need to be based on key principles of good governance, notably transparency and fairness as well as equity and social justice, all of which may be strengthened both during and post-pandemic.
ABSTRACT
COVID-19 has affected health providers economically in two main ways. First, some providers lost income due to postponed services or patients refraining from seeking care. Second, other providers took on new tasks by treating (high volumes of) COVID-19 patients. All providers faced higher costs due to new hygiene and distance requirements. We reviewed if and how countries have adjusted payments to health providers during 2020 using an analytical framework and data from 20 countries. The analysis is based on information collected in the COVID-19 Health System Response Monitor (HSRM) and complemented by grey literature by country representatives who are experts on health policy and have reported the developments and responses to the pandemic since is very onset. We found that payments were not adjusted for many providers whose income did not depend on activity such as salaries, capitations and budgets. Most of the compensatory payments were in the form of new salaries and budgets that substituted activity-based payments, and some higher fees to compensate for activity shortfalls. New FFS payments were created to incentivize virtual services. Payments for COVID-19 related costs included mainly new fees for services. Hospitals also received new budgets to cover the costs of adjusting wards, creating new (ICU) beds, and hiring more workforce. Some countries also created new per diem and DRG tariffs to pay for COVID-19 patients. Consumables such as personal protective equipment and hygiene material were provided in-kind or reimbursed in-cash. Overall, governments bore many COVID-19 financial risks. Payment adjustments should be carefully designed in order to protect providers from income shortfalls without undermining productivity, access or quality of care. Payments for COVID-19 services should promote provision without leading to overtreatment or overspending.
ABSTRACT
COVID-19 has affected the incomes of some health professionals by reducing demand for care and increasing expenditures for treatment preparedness. In a survey of 14 European countries, we found that most countries have incentivised substitutive e-health services to avoid loss of income. Health professionals have also received financial compensation for loss of income either through initiatives specifically designed for the health sector or general self-employment schemes, and have either been reimbursed for extra COVID-19-related expenditures such as personal protective equipment (PPE) or had these provided in kind. Compensation is generally funded from health budgets, complemented by emergency funding from government revenue.
ABSTRACT
All countries in Europe will have to find solutions to protect hospitals from revenue shortfalls and to adequately reimburse for COVID-19-related costs of care. This article reports on changes to hospital payment systems in Belgium, Bulgaria, the Czech Republic, Finland, France, Germany, Israel, Poland, Romania, Switzerland, and the United Kingdom (England). Hospitals in these countries are paid for treating COVID-19 patients using the usual system, modified Diagnosis Related Groups or new mechanisms. In many countries, hospitals receive their usual budgets or new money to compensate for revenue shortfalls. Only a few countries are paying non-contracted providers.