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Reimbursement summary for angioplasty of arteries of lower extremities

This post presents an extract from our reimbursement analysis for angioplasty of arteries lower extremities using plain and drug-coated balloons (DCBs) for peripheral artery disease in England, France and Germany. Plain balloon angioplasty is reimbursement via DRG solely and DCBs are reimbursement via combination of DRG and add-on reimbursement.
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The 2021/22 National Tariff Payment System came into effect in England

On September 30, 2021, the 2020/21 National Tariff Payment System (NTPS) was published in England and came into effect on October 01, 2021. The NTPS is used by commissioners and providers of secondary healthcare. It sets the rules and prices that commissioners use to pay providers (such as acute hospital trusts) for NHS services.

2021/22 NTPS introduced the new aligned payment and incentive model for all secondary care and removed almost all national prices. The most published prices are now "unit prices", which are not mandatory, and National prices continue to apply to diagnostic imaging services only.

Some key changes in the new payment model are outlined below:

  • The aligned payment and incentive approach became the central part of the National Tariff. It is a combination of fixed (global budget) and variable (activity/quality-based) funding;
  • The role of HRG is now limited to cases when the new model does not apply (e.g., providers outside the regular responsibilities of CCGs with the amount of contract less than £10 million) and for a flexible component of the novel system (e.g., for excess care, which will be paid using 50% of national HRG tariff);
  • From 2021/22, there are no separate innovation payment options.
  • The innovative products list (Annex A, tab 14c) includes technologies supported by MedTech Funding Mandate. These products have to be implemented by commissioners and reimbursed under local pricing arrangements;
  • There have been no principal policy changes for the Best Practice Tariff (BPT). The day case and outpatient procedures BPTs were discontinued.

In addition, as part of the response to Covid-19, the NHS has adopted special payment arrangements for 2021/22. Under these arrangements, most providers and commissioners have moved to block contract payments "on-account." The guidance on payment and contracting for these arrangements is available here.

See the full details here.

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