Designing and Implementing Health Care Provider Payment Systems

How-To Manuals

John C. Langenbrunner, Cheryl Cashin, Sheila O'Dougherty

• Publisher: World Bank Publications
• Year: 2009
• eBook ISBN:
  9780821378243
• Topic: Medicine
• Subtopic: Health Care Delivery

Strategic purchasing of health services involves a continuous search for the best ways to maximize health system performance by deciding which interventions should be purchased, from whom these should be purchased, and how to pay for them. In such an arrangement, the passive cashier is replaced by an intelligent purchaser that can focus scarce resources on existing and emerging priorities rather than continuing entrenched historical spending patterns. Having experimented with different ways of paying providers of health care services, countries increasingly want to know not only what to do when paying providers, but also how to do it, particularly how to design, manage, and implement the transition from current to reformed systems. 'Designing and Implementing Health Care Provider Payment Systems: How-To Manuals' addresses this need. The book has chapters on three of the most effective provider payment systems: primary care per capita (capitation) payment, case-based hospital payment, and hospital global budgets. It also includes a primer on a second policy lever used by purchasers, namely, contracting. This primer can be especially useful with one provider payment method: hospital global budgets. The volume's final chapter provides an outline for designing, launching, and running a health management information system, as well as the necessary infrastructure for strategic purchasing.

Table of contents

• Contents
• Preface
• Acknowledgments
• List of Contributors
• Abbreviations
• Glossary
• Overview: What, How, and Who: An Introduction to Provider Payment Systems
• 1. Primary Health Care Per Capita Payment Systems
• 2. Case-Based Hospital Payment Systems
• 3. Hospital Global Budgeting
• 4. A Primer on Contracting
• 5. Health Management Information Systems: Linking Purchasers and Providers
• Index
• Boxes
• Figures
• Screenshots
• Tables