International Journal of Health Policy and Management

International Journal of Health Policy and Management

Optimisation of Healthcare Contracts: Tensions Between Standardisation and Innovation; Comment on “Competition in Healthcare: Good, Bad or Ugly?”

Document Type : Commentary

Authors
Misja Mikkers 1, 2, 3
Padhraig Ryan 4
1 NZa, Dutch Healthcare Authority, Utrecht, The Netherlands
2 Free University of Amsterdam, Amsterdam, The Netherlands
3 TILEC, Tilburg University, Tilburg, The Netherlands
4 Centre for Health Policy and Management, Trinity College Dublin, Dublin 2, Ireland
10.15171/ijhpm.2015.189
Abstract
An important determinant of health system performance is contracting. Providers often respond to financial incentives, despite the ethical underpinnings of medicine, and payers can craft contracts to influence performance. Yet contracting is highly imperfect in both single-payer and multi-payer health systems. Arguably, in a competitive, multi-payer environment, contractual innovation may occur more rapidly than in a single-payer system. This innovation in contract design could enhance performance. However, contractual innovation often fails to improve performance as payer incentives are misaligned with public policy objectives. Numerous countries seek to improve healthcare contracts, but thus far no health system has demonstrably crafted the necessary blend of incentives to stimulate optimal contracting.
Keywords
Healthcare
Competition
Contracts
Innovation
Performance
Subjects
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  • Received Date 16 September 2015
  • Revised Date 13 October 2015
  • Accepted Date 13 October 2015
  • First Published Date 01 February 2016
  • Published Date 01 February 2016