Innovative payment schemes

On the 14th of March of 2019, the Dutch National Health Care Institute has opened a project submission period in a framework of subsidy scheme called “Promising care.” This scheme makes it possible to obtain temporary financing for a maximum of 6 years for those treatment methods that look promising but are not yet reimbursed from the basic package. The period for submitting project ideas for promising care is from March 14 to May 14, 2019.

Promising care must find its way to patients more quickly through inclusion in the basic health insurance. That is why the Dutch Ministry of Health, Welfare and Sport has adjusted the promising care with the new subsidy scheme. Dutch Healthcare Institute (Zorginstituut Nederland, ZIN) carries out the scheme in collaboration with the Dutch Organization for Health Research and Development (Nederlandse organisatie voor gezondheidsonderzoek en zorginnovatie, ZonMw). The scheme will replace existing procedure with conditional reimbursement of medical technologies.

Payment-for-performance schemes in health care remain controversial as there is no solid evidence that they improve quality of care. A new study, published in Health Policy by Herbst et al, did not show any positive long-term effects of the implementation of P4P on quality of care. The program was implemented within the integrated contract framework between one ophthalmological clinic and one statutory health insurance company in Germany.

Although the report excluded medical technologies from scope, it includes useful information about the concept of innovative payment schemes, taxonomy, challenges of such approaches and provides an overview of international experience.