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180702 r ||| eng |
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|a Struckmann, Verena
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|a How to strengthen financing mechanisms to promote care for people with multimorbidity in Europe?
|h Elektronische Ressource
|c Verena Struckmann, Wilm Quentin, Reinhard Busse, Ewout van Ginneken ; on behalf of the ICARE4EU consortium
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|a Copenhagen, Denmark
|b European Observatory on Health Systems and Policies
|c 2017, 2017
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|a 1 PDF file (26 pages)
|b illustrations
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|a Includes bibliographical references
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|a Multiple Chronic Conditions / economics
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|a Health Policy
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|a Delivery of Health Care, Integrated / economics
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|a Europe
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|a Quentin, Wilm
|e [author]
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|a Busse, Reinhard
|e [author]
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|a Ginneken, Ewout van
|e [author]
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|a ICARE4EU (Project)
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|a European Observatory on Health Systems and Policies
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|a World Health Organization
|b Regional Office for Europe
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|a eng
|2 ISO 639-2
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|b NCBI
|a National Center for Biotechnology Information
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|a Policy brief
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|a At head of title: Health systems and policy analysis
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|u https://www.ncbi.nlm.nih.gov/books/NBK464560
|3 Volltext
|n NLM Bookshelf Books
|3 Volltext
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|a 610
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|a 330
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|a budget, capitation, Fee For Service and DRGs) and include:1.1. Pay for coordination (P4C) which rewards the provider coordinating care.1.2. Shared-savings models which divide savings (against historical or other benchmarks) between payers and providers.1.3. Bundled payments where the onus is on providers to combine suitable services for patients' needs.1.4. Pay for performance (P4P) which can also be adapted to reflect multimorbidity and incentivize better quality care.6. Complex payment mechanisms do not work without extensive data on cost but also on quality.7. Policy makers introducing financing mechanisms to support integrated care must therefore:1.1. Improve information systems so that they can support complex payments.1.2. Carefully assess the local context and whether the system in place will be able to cope.1.3. Make sure that new payment systems do not overburden local provision and management structures1.4.
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|a Take an incremental approach to introducing new, more complex systems.8. Policy makers should also put in place funding guarantees (short- and long-term) for start up programmes or ensure a real prospect of rapid inclusion in 'mainstream' funding, so that providers are not deterred from innovating.9. Other pre-requisites for the successful implementation of new financing mechanisms are:1.1. Strong leadership and1.2. Supportive governance structures at national and programme level.1.3. Providers with sufficient reserves to assume financial risks (especially in case of broader payments)10. Policy-makers should also ensure continuous long-term evaluation of effectiveness to inform future policy
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|a 1. The growing prevalence of people with multimorbidity will increasingly require new payment mechanism that better account for the presence of multiple chronic diseases and promote better coordination and integration of care.2. Payment mechanisms can provide key incentives for providers to collaborate. Well-designed approaches encourage multiple providers to work together and enable better care, while mechanisms that pay individual providers separately can block effective integration.3. Payment mechanisms need to adequately account for the complexity of cases treated and will inevitably be relatively complex themselves.4. Evaluations of several integrated care programmes suggest that these can lead to savings particularly through, increased multi-professional collaboration, polypharmacy management and innovative, integrative technologies - all of which can be stimulated by payments.5. Innovative payment mechanisms can be combined with more traditional payment (e.g.
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