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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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NHS Improvement has published proposals for 2019/20 National Tariff Payment System

22 Nov 2018

The proposed changes to the payment system in 2019/20 nclude changes to:

  • duration of the tariff;
  • payment approach for emergency care;
  • market forces factor (MFF);
  • centralised procurement;
  • maternity payment pathway.

To support these proposals, NHS Digital have published a 2019/20 engagement grouper.

It is proposed to set the next national tariff for one year.

New payment approach for emergency care includes introduction of a ‘blended’ payment approach for emergency care that would comprise a fixed amount (linked to expected levels of activity) and a volume-related element that reflects actual levels of activity.

Market forces factor (MFF) estimates the unavoidable cost differences between healthcare providers, based on their geographical location. The MFF is an important part of the NTPS. However, it has not been updated for almost 10 years. The proposal includes updating the method used for calculating the MFF and the data it is based on.

NHS Supply Chain is being reorganised and managed by a new organisation, Supply Chain Coordination Limited (SCCL). SCCL aims to increase NHS purchasing power and give providers access to lower procurement prices. maternity payment pathway. SCCL estimates that its overheads will be around £250m in 2019/20. Currently, NHS Supply Chain is funded through a mark-up on the prices it offers. The Department of Health and Social Care intends that SCCL overheads will be funded using money allocated to the national tariff. This central funding would reduce the direct cost to NHS providers of procuring supplies from SCCL.

The maternity pathway payment involves national prices for the integrated package of care offered to all pregnant women and their newborn babies. The pathway consists of three integrated packages of care covering the antenatal, birth and postnatal phases. Integrated package may include some public health services, known as Section 7A public health services, fall outside the scope of national prices in the national tariff. To address this issue, it is proposed to make all maternity prices non-mandatory.

See full details here.

The consultation was open until 29th of October 2018.

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