You get what you pay for. Toward a new business model for healthcare- Feedback

Unions of physicians, hospital representatives, sickness funds and government have diverging points of view in favor or in opposition of fundamental reforms of the payment model of physicians and hospitals. Strong statements about the consequences of payment reform for the quality and sustainability of care are being formulated towards the public. Together with the Center of Health Services and Nursing Research, KU Leuven, and the Department of Public Health, U Gent, Itinera presents a constructive and scientifically sound middle ground that retains the positive elements of the current payment system, yet also induces reform for the good of the patient, where necessary. It concerns the most ambitious, but also highly needed reform to keep our health system sustainable since the 50’ies. Without implementation, government expenses will derail in a structural manner during the coming years and the quality of care would be jeopardized.

The Itinera proposal, developed in collaboration with KULeuven and UGent, uses a scientific basis to present the middle ground: A thorough combination of fixed and variable payment, independent yet aligned between physicians and hospitals, based on justifiable costs. In addition, unintended consequences should be countered by a true fully performance based payment share based on quality of care as measured. In most sectors outside health care such a balanced combination is common practice. This reform provides the opportunity for Belgium to leapfrog above and beyond the position of other countries by adopting a better payment system of coordination of care with the patient at the centre.