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Balancing financial incentives during COVID-19: A comparison of provider payment adjustments across 20 countries.
Waitzberg, Ruth; Gerkens, Sophie; Dimova, Antoniya; Bryndová, Lucie; Vrangbæk, Karsten; Jervelund, Signe Smith; Birk, Hans Okkels; Rajan, Selina; Habicht, Triin; Tynkkynen, Liina-Kaisa; Keskimäki, Ilmo; Or, Zeynep; Gandré, Coralie; Winkelmann, Juliane; Ricciardi, Walter; de Belvis, Antonio Giulio; Poscia, Andrea; Morsella, Alisha; Slapsinskaite, Agne; Miscikiene, Laura; Kroneman, Madelon; de Jong, Judith; Tambor, Marzena; Sowada, Christoph; Scintee, Silvia Gabriela; Vladescu, Cristian; Albreht, Tit; Bernal-Delgado, Enrique; Angulo-Pueyo, Ester; Estupiñán-Romero, Francisco; Janlöv, Nils; Mantwill, Sarah; Van Ginneken, Ewout; Quentin, Wilm.
  • Waitzberg R; 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.
  • Gerkens S; Belgian Health Care Knowledge Centre, Belgium. Electronic address: Sophie.Gerkens@kce.fgov.be.
  • Dimova A; Faculty of Public Health, Medical University - Varna, Bulgaria. Electronic address: ant_dimova@abv.bg.
  • Bryndová L; Center for Social and Economic Strategies, Faculty of Social Science, Charles University, Czechia. Electronic address: lucie.bryndova@fsv.cuni.cz.
  • Vrangbæk K; University of Copenhagen, Department of Public Health, Section for Health Services Research, Copenhagen, Denmark. Electronic address: kv@ifs.ku.dk.
  • Jervelund SS; University of Copenhagen, Department of Public Health, Section for Health Services Research, Copenhagen, Denmark. Electronic address: ssj@sund.ku.dk.
  • Birk HO; University of Copenhagen, Department of Public Health, Section for Health Services Research, Copenhagen, Denmark. Electronic address: hob@sund.ku.dk.
  • Rajan S; London School of Hygiene and Tropical Medicine, London, UK. Electronic address: Selina.Rajan@lshtm.ac.uk.
  • Habicht T; WHO Barcelona Office for Health Systems Financing, Spain. Electronic address: habichtt@who.int.
  • Tynkkynen LK; Tampere University, Faculty of Social Sciences, Finland. Electronic address: liina-kaisa.tynkkynen@tuni.fi.
  • Keskimäki I; Finnish Institute for Health and Welfare and Tampere University, Faculty of Social Sciences, Finland.
  • Or Z; Institute for Research and Information in Health Economics, France. Electronic address: or@irdes.fr.
  • Gandré C; Institute for Research and Information in Health Economics, France. Electronic address: gandre@irdes.fr.
  • Winkelmann J; Department of Health Care Management, Faculty of Economics & Management, Technische Universität Berlin, Germany. Electronic address: Juliane.winkelmann@tu-berlin.de.
  • Ricciardi W; Section of Hygiene, University Department of Life Sciences and Public Health-Università Cattolica del Sacro Cuore, Italy. Electronic address: Walter.ricciardi@unicatt.it.
  • de Belvis AG; Section of Hygiene, University Department of Life Sciences and Public Health-Università Cattolica del Sacro Cuore, Italy. Electronic address: Antonio.debelvis@unicatt.it.
  • Poscia A; 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.
  • Morsella A; Section of Hygiene, University Department of Life Sciences and Public Health-Università Cattolica del Sacro Cuore, Italy. Electronic address: Alisha.morsella@unicatt.it.
  • Slapsinskaite A; Faculty of Public Health, Health Research Institute, Medical Academy, Lithuanian University of Health Sciences, Lithuania. Electronic address: agne.slapsinskaite@lsmuni.lt.
  • Miscikiene L; Faculty of Public Health, Health Research Institute, Medical Academy, Lithuanian University of Health Sciences, Lithuania. Electronic address: Laura.Miscikiene@lsmuni.lt.
  • Kroneman M; Netherlands Institute of Health Services Research, Utrecht, the Netherlands. Electronic address: m.kroneman@nivel.nl.
  • de Jong J; Netherlands Institute of Health Services Research, Utrecht, the Netherlands. Electronic address: j.dejong@nivel.nl.
  • Tambor M; 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.
  • Sowada C; 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.
  • Scintee SG; National School of Public Health, Management and Professional Development Bucharest, Romania. Electronic address: sscintee@snspms.ro.
  • Vladescu C; National School of Public Health, Management and Professional Development Bucharest, Faculty of Medicine, University Titu Maiorescu, Romania. Electronic address: cvladescu@snspms.ro.
  • Albreht T; National Institute of Public Health of Slovenia, Department of Public Health, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia. Electronic address: tit.albreht@nijz.si.
  • Bernal-Delgado E; Data Sciences for Health Services and Policy Research. Institute for Health Sciences in Aragon (IACS), Spain. Electronic address: ebernal.iacs@aragon.es.
  • Angulo-Pueyo E; Data Sciences for Health Services and Policy Research. Institute for Health Sciences in Aragon (IACS), Spain. Electronic address: eangulop.iacs@aragon.es.
  • Estupiñán-Romero F; Data Sciences for Health Services and Policy Research. Institute for Health Sciences in Aragon (IACS), Spain. Electronic address: festupinnan.iacs@aragon.es.
  • Janlöv N; Swedish Agency for Health and Care Services Analysis. Electronic address: Nils.Janlov@vardanalys.se.
  • Mantwill S; University of Lucerne Department of Health Sciences and Medicine, Switzerland. Electronic address: Sarah.Mantwill@unilu.ch.
  • Van Ginneken E; European Observatory on Health Systems and Policies, Belgium. Electronic address: ewout.vanginneken@tu-berlin.de.
  • Quentin W; 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.
Health Policy ; 126(5): 398-407, 2022 05.
Article in English | MEDLINE | ID: covidwho-1540637
ABSTRACT
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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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Experimental Studies / Prognostic study Limits: Humans Language: English Journal: Health Policy Journal subject: Health Services Research / Public Health Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Experimental Studies / Prognostic study Limits: Humans Language: English Journal: Health Policy Journal subject: Health Services Research / Public Health Year: 2022 Document Type: Article