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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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Significant changes in the payment system in England expected from April 2021

19 Mar 2021

NHS England and Improvement (NHSEI) is currently developing National Tariff Payment System (NTPS) for 2021/22. In November 2020, NHSEI released the 2021/22 Tariff engagement document and initiated a feedback survey.

According to this document, the main change expected from April 2021 is introducing a consistent blended payment approach across almost all specialist healthcare services, including both the acute and non-acute sectors, in line with the NHS Long Term Plan (LTP) objective of moving to population-based funding. This would greatly broaden the scope of blended payments and would replace the individual service-level blended payments introduced in previous tariffs.

The blended payment model for 2021/22 would include a fixed payment based on the costs of delivering a level of activity that conforms to the Integrated Care System (ICS) plan and a variable element for some elective activity.

Alongside the blended payment arrangements, providers and commissioners would need to sign up a System Collaboration and Financial Management Agreement (SCFMA) under the terms of the NHS Standard Contract. The SCFMA would serve to share financial risk across the system.

Implementing the blended payment arrangements would have a significant impact on the operation of the NTPS. While NHSEI will continue to calculate and publish prices, the majority of these would be unit prices for services outside the scope of blended payment rather than national (i.e., mandated) prices.

See the full details here.

This news is just one of about 300 market access news collected by our team in the subscription services "HTA Alerts" and "Reimbursement Alerts" every two weeks from more than 80 organizations. Access our paid subscription services to stay on top of all developments specifically for your products in Europe (reimbursement news) and globally (HTA news). First EU issues of both newsletters are available for download free-of-charge.

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