Reforms for quality payment in Europe: situation, analysis and proposals

Abstract

Due to high pressure concerning budget containment in OECD health systems financing, regulators try to implement economic efficiency, assessing quality of care to offer the best services for all the covered population. Since the 2000 local and national programs were developed proposing financial incentives dedicated to quality for first line professionals as for hospitals too. We have listed and analyzed the bibliography concerning these programs in Europe and in USA, and we have solicited for an interview professionals involved in healthcare sector. Results concerning Payment For Performance programs in Europe and abroad, demonstrate most often only a slight quality improvement on registered indicators. Nevertheless, our study reveals a high interest for healthcare professionals concerning stable programs including complementary fees added to DRG hospitals payment. We open then a discussion based on several proposals considering long term reinforcement of actual French payment model.