PD61 What Are The Drivers Of Transitioning From Fee-For-Service To Value-Based Payment Models In The Brazilian Private Healthcare System?

Abstract

IntroductionThe Brazilian National Agency for private healthcare system (ANS) makes the regulation for private healthcare system in Brazil. ANS, since 2019, is running the pilot value-based new payment models project. In total, 13 projects were selected by ANS. This research aims to identify the key drivers for moving from fee for service (FFS) to value-based payment models in the Brazilian healthcare private system.MethodsWe interviewed managers of private healthcare plans (13 in total) participating in the Value-Based Payment Models run by ANS. Data were collected through semi-structured interviews during 2021. Twelve managers were invited to the interview and eight accepted the invitation. The key questions were: “Why are healthcare providers transitioning from the fee for service model to value-based models?” and “What are your motivations to participate in the ANS project?” For data analysis, Bardin’s content analysis was chosen. Data validation was performed using the debriefing technique.ResultsThe main reasons for transitioning from FFS to value-based models were related to weaknesses of FFS (58%), strengths of the value-based payment model (14%) and sector needs (14%). Fee-for-service weaknesses are related to financial impacts – including waste and unsustainability (55%), and lack of transparency – including lack of trust and conflict of interest (28%). Strengths of the value-based payment model were related to financial benefits (100%), in other words, greater return on investment. The key unmet needs of the sector are related to improvement of the financial status - including lower costs and less waste (71%), and improvement of care delivery quality (29%). Continuity was reported as a benefit of FFS, according to 43 percent of respondents.ConclusionsOur results suggest that financial motivations are the main reason to transition from fee-for-service to value-based models.

Identifying patterns of utilization of single-use video laryngoscopy and supraglottic airway devices to reduce waste

“…A s health care reimbursement models in the United States shift to Value-based Care, health care providers are under increased pressure to optimize resource utilization while delivering high-quality care [1] . Lean management, a systematic method of reducing waste in manufacturing, is one approach that has successfully led to quality improvement and cost reduction within health care systems [2][3][4][5] .…”