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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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2021/22 NHS Standard Contract published in England

06 Apr 2021

On March 22, 2021, NHS England published the final version of the 2021/22 NHS Standard Contract and associated documents, which took effect from April 01, 2021. NHS England mandates the NHS Standard Contract for use by commissioners for all healthcare services contracts other than primary care. There is no requirement for NHS commissioners and Trusts to sign contracts for 2021/22 by April 01, 2021. The nationally mandated terms of the NHS Standard Contract for 2021/22 will nonetheless apply, and a contract incorporating those nationally mandated terms will be implied as being in place between the parties.

A summary of changes can be found in section 2 of the NHS Standard Contract Technical Guidance, and it includes the following:

  • The use of alternatives (video/telephone) to traditional face-to-face outpatient appointments is now a key tool safely and conveniently maximizing NHS capacity. A requirement to offer patients, wherever clinically appropriate, a remote consultation option is added;
  • NHS England published national guidance on evidence-based interventions in 2018, covering 17 specific interventions, and the Contract already requires compliance with this. National guidance on the second set of 31 additional interventions has now been endorsed by NHS England and Improvement and published on the Academy of Medical Royal Colleges website. A Contract is now including reference to this second set of guidance;
  • The nationally set financial sanctions in relation to national quality standards were removed;
  • The proposed 2021/22 National Tariff Payment System introduces new "Aligned Payment and Incentive" (API) rules. New references were included in the Contract to the API rules, with a schedule in which the agreed API details can be recorded;
  • From April 2021, Commissioning for Quality and Innovation (CQUIN) is governed by the API rules. The financial value of CQUIN will remain at 1.25% (as a proportion of the fixed element of payment). It is paid in full to the provider in advance monthly, but the commissioner will sanction any underperformance, depending on the provider's performance against the relevant nationally set CQUIN indicators. Amendments to the Contract wording related to arrangements for monitoring CQUIN performance and validating payment were made to enable these changes.

See the full details here.

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