Naar een nieuw geïntegreerd gemengd financieringsmodel voor de huisartspraktijk

Abstract

A new integrated mixed payment model for general practitioners in Belgium Belgian primary care faces a number of challenges, exacerbated by the COVID-19 pandemic: an increasing percentage of elderly people, changing family structures, a shrinking labour market, health inequities, rapid and sometimes costly technological innovations, etc. The ‘quintuple aim’ was set as a goal to organise equitable and cost-effective, high-quality care to secure the health of citizens and the well-being of healthcare workers. There’s a growing consensus that a dominantly fee-for-service system is not fit to respond to the challenges. This article proposes a third mixed payment model, besides the 2 existing models, i.e. a fee for service and a capitation model. In this new model, the general practitioner’s income will be based for 60/70% on capitation and for 40/30% on fee for service. The income via capitation will depend on the characteristics of the patient population (age, socioeconomic status and maybe gender). Important conditions to implement this new model are a complete registration of all citizens in a primary care practice as well as monitoring of the number of consultations and home visits. Importantly, all forms of teleconsultations will be paid under the capitation part and the face-to-face encounters under the fee-for-service system. This new mixed model may cause some income shifts between general practitioners. Therefore, a thorough simulation at practice and care provider level is necessary before implementation.