Models of funding and reimbursement in health care : a conceptual framework
By: DEBER, Raisa
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Contributor(s): HOLLANDER, Marcus J | JACOBS, Philip.
Material type: 
ArticlePublisher: Toronto : IPAC, September/Septembre 2008Canadian Public Administration 51, 3, p. 381-405Abstract: What is the best way to pay providers to deliver health services? The research evidence strongly suggests that there is no single answer; rather, one must consider the incentives and disincentives inherent in alternative health-care funding models. This article suggests a conceptual framework for categorizing payment mechanisms that highlights different policy options and their associated tradeoffs. It concentrates on the following: distinctions between need, demand, and utilization as they affect the rationale for government involvement; models of the possible funding flows (two-way, three-way, and four-way) as they affect policy levers; and implications of various approaches to payment. The framework is then used to clarify the advantages and disadvantages of particular approaches to financing health care and to clarify the tradeoffs involved
What is the best way to pay providers to deliver health services? The research evidence strongly suggests that there is no single answer; rather, one must consider the incentives and disincentives inherent in alternative health-care funding models. This article suggests a conceptual framework for categorizing payment mechanisms that highlights different policy options and their associated tradeoffs. It concentrates on the following: distinctions between need, demand, and utilization as they affect the rationale for government involvement; models of the possible funding flows (two-way, three-way, and four-way) as they affect policy levers; and implications of various approaches to payment. The framework is then used to clarify the advantages and disadvantages of particular approaches to financing health care and to clarify the tradeoffs involved
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