Paying hospital specialists: Experiences and lessons from eight high-income countries

Quentin, Wilm; Geißler, Alexander; Wittenbecher, Friedrich; Ballinger, Geoff; Berenson, Robert A.; Bloor, Karen; Forgione, Dana A.; Köpf, Peer; Kroneman, Madelon; Serdén, Lisbeth; Suárez, Raúl Loria; Manen, Johan W. van; Busse, Reinhard

doi:10.1016/j.healthpol.2018.03.005

Cited by 32 publications

(37 citation statements)

References 31 publications

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“…Many physicians in our study noted that a blended model (that retains aspects of both salary- and FFS-based components) might be ideal, as it may offer the right mix of incentives to many physicians. This is consistent with the shift toward blended payment systems in many developed health systems across the world ( Quentin et al 2018 ). Blended payment models can take on different forms, wherein usually two types of payment models are variably combined into one to pay physicians (e.g., FFS plus capitation, capitation plus pay for performance).…”

Section: Discussionsupporting

confidence: 83%

Optimizing Physician Payment Models to Address Health System Priorities: Perspectives from Specialist Physicians

Ogundeji

Quinn

Lunney

et al. 2021

hcpol

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Objective: Despite well-documented data on the mixed impact of physician payment models, there is limited evidence on how to enhance existing payment model designs. This study examines the approaches to optimizing payment models from the perspective of specialist physicians to better support patient and physician experience and other health system objectives. Method: Semi-structured interviews were conducted with 32 specialist physicians across Alberta, Canada. Data from the interviews were analyzed using a framework approach. Results: Respondents emphasized the need to incentivize physicians with the right blend of financial and non-financial incentives, including physician wellness. Respondents also highlighted the need for physician involvement and accountability to optimize the value of physician payment models. Conclusion:To optimize physician payment models, it may be useful to include a blend of financial and non-financial incentives with clear accountability measures as this may better align physician practice with health system priorities. RésuméObjectif : Malgré des données bien documentées sur l'impact mixte des modèles de rémunération des médecins, il existe peu de données sur la façon d' améliorer les modèles existants. Cette étude examine l' optimisation des modèles de paiement du point de vue des médecins spécialistes afin de mieux soutenir l' expérience des patients et des médecins ainsi que d' autres objectifs du système de santé. Méthode : Des entrevues semi-structurées ont été menées auprès de 32 médecins spécialistes de l' Alberta, au Canada. Les données des entretiens ont été analysées à l' aide d' une approche cadre. Résultats : Les répondants ont souligné la nécessité de persuader les médecins avec le bon mélange d'incitatifs financiers et non financiers, notamment des incitatifs concernant leur bien-être. Les répondants ont également souligné la nécessité de la participation et de la responsabilisation des médecins pour optimiser la valeur des modèles de rémunération des médecins. Conclusion : Afin d' optimiser les modèles de rémunération des médecins, il peut être utile de prévoir un mélange d'incitatifs financiers et non financiers avec des mesures de responsabilisation claires, car cela peut permettre de mieux aligner la pratique des médecins sur les priorités du système de santé.

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Section: Discussionsupporting

confidence: 83%

Optimizing Physician Payment Models to Address Health System Priorities: Perspectives from Specialist Physicians

Ogundeji

Quinn

Lunney

et al. 2021

hcpol

View full text Add to dashboard Cite

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“…Based on the modification of the waste relationship matrix, the waste of human skills or potential or talent is closely ISSN: 2722-4015 http://ijstm.inarah.co.id related to generate the other seven wastes in service. The waste of human skills must be eliminated and recommendations for continuous improvement are found to improve emergency services in the era of covid19 [23].…”

Section: Fig 3 Analysis the Cause Of Critical Waste Of Human Skill At Fishbone Diagrammentioning

confidence: 99%

Framing Improvement of Emergency Services RSKJ Soeprapto Hospital with Lean and WAM Modification

Mahadewi

Heryana

Yumita³

et al. 2021

International Journal of Science, Technology & Management

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The present study reports the first comprehensive research on covid19 emergency services model. Healthcare services inside hospitals during pandemic can apply the Lean Hospital and Waste Assessment Model (WAM) modification, which is a new method that can be used to identify waste in the hospital service process flow and operational of emergency service. The purpose of this study is to provide recommendations for improving emergency services in the covid19 era. The method used in this research is a descriptive qualitative analysis carried out through observing the service flow of patients who will be hospitalized from the emergency, confirming the service flow by in-depth interviews and looking at secondary data and giving a questionnaire on a modification of eight waste relationship at 15 persons expert who understands the emergency service process. The results showed that the critical waste of emergency services at RSKJ Soeprapto hospital is a waste of human skills of 17.5%. The reasons for the emergence above are because the covid19 team has not yet been formed, the absence of special officers to conduct primary triage before the patient enters the emergency unit, and many officers who do not understand the flow of emergency services in the covid19 pandemic era. In order to improve hospital services in the future, it is necessary to form a covid19 team, to develop a standard emergency service guide, to conduct continuous socialization to all the hospital staff through education and training programs, which are recommendations for improving emergency services at RSKJ Soeprapto Hospital Bengkulu in the pandemic era and new normal preparation.

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“…84 At present, wages for non-physician hospital employees are generally lower at for-profit than at nonprofit hospitals, a reversal of the pattern in 1990. 85 In contrast, for-profits often offer physicians lucrative arrangements in the form of incentive-based payments 86 or a share of hospital profits. 87 Recent Developments: The Affordable Care Act, the Trump Administration, and the COVID-19 Crisis.…”

Section: The United Statesmentioning

confidence: 99%

For-Profit Hospitals Have Thrived Because of Generous Public Reimbursement Schemes, Not Greater Efficiency: A Multi-Country Case Study

et al. 2020

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For-profit hospitals’ market share has increased in many nations over recent decades. Previous studies suggest that their growth is not attributable to superior performance on access, quality of care, or efficiency. We analyzed other factors that we hypothesized may contribute to the increasing role of for-profit hospitals. We studied the historical development of the for-profit hospital sector across 4 nations with contrasting trends in for-profit hospital market share: the United States, the United Kingdom, Germany, and the Netherlands. We focused on 3 factors that we believed might help explain why the role of for-profits grew in some nations but not in others: (1) the treatment of for-profits by public reimbursement plans, (2) physicians’ financial interests, and (3) the effect of the political environment. We conclude that access to subsidies and reimbursement under favorable terms from public health care payors is an important factor in the rise of for-profit hospitals. Arrangements that aligned financial incentives of physicians with the interests of for-profit hospitals were important in stimulating for-profit growth in an earlier era, but they play little role at present. Remarkably, the environment for for-profit ownership seems to have been largely immune to political shifts.

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Paying hospital specialists: Experiences and lessons from eight high-income countries

Cited by 32 publications

References 31 publications

Optimizing Physician Payment Models to Address Health System Priorities: Perspectives from Specialist Physicians

Optimizing Physician Payment Models to Address Health System Priorities: Perspectives from Specialist Physicians

Framing Improvement of Emergency Services RSKJ Soeprapto Hospital with Lean and WAM Modification

For-Profit Hospitals Have Thrived Because of Generous Public Reimbursement Schemes, Not Greater Efficiency: A Multi-Country Case Study

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