Better Ways to Pay for Health Care

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Payers for health care are pursuing a variety of policies as part of broader efforts to improve the quality and efficiency of care.  Payment reform is but one policy tool to improve health system performance that requires supportive measures in place such as policies with well-developed stakeholder involvement, information on quality, clear criteria for tariff setting, and embedding evaluation as part of the policy process. Countries should not, however, underestimate the significant data challenges when looking at price setting processes. Data access and ways to overcome its fragmentation require well-developed infrastructures. Policy efforts highlight a trend towards aligning payer and provider incentives by using evidence-based clinical guidelines and outcomes to inform price setting. There are signs of increasing policy focus on outcomes to inform price setting. These efforts could bring about system-wide effects of using evidence along with a patient-centred focus to improve health care delivery and performance in the long-run.



Foreword and acknowledgements

In nearly all industries, payments for services or products reflect short-term performance or long-term value. Yet in health care, most payments to health providers have done neither. Instead, they have often simply rewarded greater volume of services whether needed or not. Recently, attention has moved away from rewarding volume of health care to quality and efficiency. Changing epidemiology and care models for an ageing population, managing of patients with complex health needs and scarce resources, all make it imperative to change how we pay for health services.


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