Payment methods for outpatient care facilities

Yuan, Beibei; He, Li; Meng, Qingyue; Jia, Lei

doi:10.1002/14651858.cd011153.pub2

Cited by 44 publications

(56 citation statements)

References 69 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Third, payment schedule was another important factor influencing health care providers' behaviour. While payment schedule is inter alia dependent on the type of a PPM, it has been shown to vary in the interval between monthly to annual payments . With respect to this range, however, our findings show that a shorter interval payment schedule is more preferred by health care providers compared to a longer one for several reasons: First, borrowing from the law of diminishing marginal returns, it can be argued that payment schedules with short intervals generate higher utility than less frequent payment which is characterised by longer interval payment schedules.…”

Section: Discussionmentioning

confidence: 60%

What characteristics of provider payment mechanisms influence health care providers' behaviour? A literature review

Kazungu

Barasa

Chuma

2018

Health Planning & Management

View full text Add to dashboard Cite

Background: Provider payment mechanisms (PPMs) create incentives or signals that influence the behaviour of health care providers. Understanding the characteristics of PPMs that influence health care providers' behaviour is essential for aligning PPM reforms for improving access, quality, and efficiency of health care services. We reviewed empirical literature that examined the characteristics of PPMs that influence the behaviour of health care providers. Methods:We systematically searched for empirical literature in PubMed, Web of Science, and Google Scholar databases and complemented these with physical searching of the references of selected papers for further relevant studies. A total of 16 studies that met our inclusion and exclusion criteria were identified. We analysed data using thematic review. Results:We identified seven major characteristics of PPMs that influence health care providers' behaviour. Of these characteristics, payment rate, the sufficiency of payment rate to cover the cost of services, timeliness of payment, payment schedule, performance requirements, and accountability mechanisms were the most important.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

show abstract

Section: Discussionmentioning

confidence: 60%

What characteristics of provider payment mechanisms influence health care providers' behaviour? A literature review

Kazungu

Barasa

Chuma

2018

Health Planning & Management

View full text Add to dashboard Cite

show abstract

“…Moreover, the results of this study may be used in other countries dealing with a high incidence of BCCs and pressure on their healthcare system. This may particularly apply to countries with a GP gatekeeper system or fee‐for‐service reimbursement systems, such as most Western countries …”

Section: Discussionmentioning

confidence: 99%

Factors influencing current low‐value follow‐up care after basal cell carcinoma and suggested strategies for de‐adoption: a qualitative study

Egmond

Wakkee

Rengen³

et al. 2019

Br J Dermatol

View full text Add to dashboard Cite

SummaryBackgroundProviding follow‐up to patients with low‐risk basal cell carcinoma (BCC) can be considered as low‐value care. However, dermatologists still provide substantial follow‐up care to this patient group, for reasons not well understood.ObjectivesTo identify factors influencing current BCC follow‐up practices among dermatologists and suggested strategies to de‐adopt this low‐value care. In addition, views of patients regarding follow‐up care were explored.MethodsA qualitative study was conducted consisting of 18 semistructured interviews with dermatologists and three focus groups with a total of 17 patients with low‐risk BCC who had received dermatological care. The interviews focused on current follow‐up practices, influencing factors and suggested strategies to de‐adopt the follow‐up care. The focus groups discussed preferred follow‐up schedules and providers, as well as the content of follow‐up. All (group) interviews were transcribed verbatim and analysed by two researchers using ATLAS.ti software.ResultsFactors influencing current follow‐up care practices among dermatologists included complying with patients’ preferences, lack of trust in general practitioners (GPs), financial incentives and force of habit. Patients reported varying needs regarding periodic follow‐up visits, preferred to be seen by a dermatologist and indicated a need for improved information provision. Suggested strategies by dermatologists to de‐adopt the low‐value care encompassed educating patients with improved information, educating GPs to increase trust of dermatologists, realizing appropriate financial reimbursement and informing dermatologists about the low value of care.ConclusionsA mixture of factors appear to contribute to current follow‐up practices after low‐risk BCC. In order to de‐adopt this low‐value care, strategies should be aimed at dermatologists and GPs, and also patients.

show abstract

“…Three Cochrane reviews [204][205][206] have explored the effectiveness of financial incentives, which highlights the need for more robust evidence on the impact of financial incentives on patient outcomes. Although incentives seem to have some effect on the behaviours of health-care professionals, this may not necessarily translate into improvements in patient outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…204 The design and format of payments vary, typically based on units or thresholds, and may be paid retrospectively or prospectively. 205,206 The vanguards recognise the need for the alignment of incentives at different levels of the system, from the individual level to the service level. 200 Current commissioning practice typically involves the management of numerous contracts, ranging in value, for different community-based services.…”

Section: Characteristics Of Place-based Contracting and Payment Systemsmentioning

confidence: 99%

The international knowledge base for new care models relevant to primary care-led integrated models: a realist synthesis

Turner¹,

Mulla²,

Aldridge³

et al. 2018

Health Serv Deliv Res

View full text Add to dashboard Cite

BackgroundThe Multispecialty Community Provider (MCP) model was introduced to the NHS as a primary care-led, community-based integrated care model to provide better quality, experience and value for local populations.ObjectivesThe three main objectives were to (1) articulate the underlying programme theories for the MCP model of care; (2) identify sources of theoretical, empirical and practice evidence to test the programme theories; and (3) explain how mechanisms used in different contexts contribute to outcomes and process variables.DesignThere were three main phases: (1) identification of programme theories from logic models of MCP vanguards, prioritising key theories for investigation; (2) appraisal, extraction and analysis of evidence against a best-fit framework; and (3) realist reviews of prioritised theory components and maps of remaining theory components.Main outcome measuresThe quadruple aim outcomes addressed population health, cost-effectiveness, patient experience and staff experience.Data sourcesSearches of electronic databases with forward- and backward-citation tracking, identifying research-based evidence and practice-derived evidence.Review methodsA realist synthesis was used to identify, test and refine the following programme theory components: (1) community-based, co-ordinated care is more accessible; (2) place-based contracting and payment systems incentivise shared accountability; and (3) fostering relational behaviours builds resilience within communities.ResultsDelivery of a MCP model requires professional and service user engagement, which is dependent on building trust and empowerment. These are generated if values and incentives for new ways of working are aligned and there are opportunities for training and development. Together, these can facilitate accountability at the individual, community and system levels. The evidence base relating to these theory components was, for the most part, limited by initiatives that are relatively new or not formally evaluated. Support for the programme theory components varies, with moderate support for enhanced primary care and community involvement in care, and relatively weak support for new contracting models.Strengths and limitationsThe project benefited from a close relationship with national and local MCP leads, reflecting the value of the proximity of the research team to decision-makers. Our use of logic models to identify theories of change could present a relatively static position for what is a dynamic programme of change.ConclusionsMultispecialty Community Providers can be described as complex adaptive systems (CASs) and, as such, connectivity, feedback loops, system learning and adaptation of CASs play a critical role in their design. Implementation can be further reinforced by paying attention to contextual factors that influence behaviour change, in order to support more integrated working.Future workA set of evidence-derived ‘key ingredients’ has been compiled to inform the design and delivery of future iterations of population health-based models of care. Suggested priorities for future research include the impact of enhanced primary care on the workforce, the effects of longer-term contracts on sustainability and capacity, the conditions needed for successful continuous improvement and learning, the role of carers in patient empowerment and how community participation might contribute to community resilience.Study registrationThis study is registered as PROSPERO CRD42016039552.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

show abstract

Payment methods for outpatient care facilities

Cited by 44 publications

References 69 publications

What characteristics of provider payment mechanisms influence health care providers' behaviour? A literature review

What characteristics of provider payment mechanisms influence health care providers' behaviour? A literature review

Factors influencing current low‐value follow‐up care after basal cell carcinoma and suggested strategies for de‐adoption: a qualitative study

The international knowledge base for new care models relevant to primary care-led integrated models: a realist synthesis

Contact Info

Product

Resources

About