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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 has published key features of the DRG package for 2020 (RZ20a)

Dutch Healthcare Authority (NZa) has released key features of the DRG package for 2020, including complex chronic lung failure, stem cell transplant care and indexation of DRG tariffs.

Many diagnoses that occur in complex chronic lung failure have been added. The change for complex chronic lung failure is a part of the project that will start in 2021. Before 2021, the NZa will investigate whether adjustments should be made to the DRG product structure and tariffs.

In the aftercare phase for stem cell transplant care, a distinction has been made between adults and children. In addition, new healthcare activities are introduced for the situation when a patient is admitted for longer than the transplant phase.

The DRG tariffs for 2020 will be indexed. However, there is an exception for some care services. NZa is currently investigating how they can improve the tariff decisions via consultations with parties about this. A number of proposals that are now being discussed:

  • The (partial) standardization of cost price calculations
  • The more intensive involvement of care-related knowledge in the assessment of cost prices
  • The more detailed control of the quality of cost prices

The schedule with the most important milestones for the DRG package 2020 can be found here.

See full details here.

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