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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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Dutch Healthcare Authority advises to implement value-based funding of medical specialist care

20 Nov 2018

Value-based contracting must become the norm so that care in the right place and efficient use of people and resources comes a step closer. New model of funding is necessary in order to keep the healthcare affordable in the long-term perspective. This is stated in the Advice on the financing of medical specialist care “Rewards of care that adds value” to the Minister of Health.

Dutch Healthcare Authority (NZa) have agreed with care providers and health insurers that they take health gains for patients as the starting point in the contracts. The incentives for this value-driven care are laid down in contracts whereby agreements are made about quality and outcomes. In these agreements, patient demand is central and is paid for in bundles of existing healthcare products. This gives the patient the right care in the right place. Transparency about the outcomes of healthcare is a precondition for this.

The DRG system has a different, less meaningful role. The medical specialist care is recorded and declared with diagnosis treatment combinations (DRG). These DRGs will continue to exist in the coming years and will be changed as little as possible. Innovative agreements in contracts benefit from a stable declaration system. DRG healthcare products become less significant in the financial agreements between care providers and health insurers.

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