The Impact of Value-Based Healthcare Reimbursement Models on Healthcare Organizations: (Review Artical) | ||||
| The Medical Journal of Cairo University | ||||
| Volume 88, December, December 2020, Page 2455-2460 PDF (204.07 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/mjcu.2020.356789 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| GHADYAN SALEM AL SHAMMARY, YOUSSEF SANT AWAD ELRASHEDY, MOTEB ROSHAID AL-SHAMARI, MOTEB FREAH AL SHAMMARI, SULTAN FARES ALSHAMARI,; SHAIME HALEL AL ENAZI, OBAID SAMAH AL RASHIDI, SAMI FARHAN ALSHARARI, AHMED SHEMAN AL SHARARI, ABDULAZIZ SHAEM AL SHARARI, AMMASH OTHEAH AL SHARARI,; ABDULKHAREEM GATHEN AL SHAMMARY MOSA GHANEM AL RASHIDI | ||||
| KSA, National Guard Health Affairs | ||||
| Abstract | ||||
| Background: In the ongoing effort to create a healthcare system that can be maintained throughout time, value-based reimbursement techniques have been explored. Success for deployed models is determined by analyzing precise data of patients’ consumption profile in relation to their clinical state and the risk balance among all stakeholders. The use of pre-cise patient-level cost and outcome data differs across various payment methods, including as fee-for-service and value-based bundled payment models, leading to the establishment of dis-tinct risk agreements among stakeholders. Aim of Study: To ensure the healthcare system remains financially sustainable and delivers social consequences, it is crucial to have a comprehensive grasp of value-based reim-bursement agreements and recognize them as a means of man-aging risks. This study provides a detailed examination of how value-based reimbursement systems affect the healthcare sys-tem, including both social and financial aspects. Methods: The study used a rigorous examination of the existing literature on value-based reimbursement to determine the specific effects of various techniques on healthcare sys-tems. Following the literature review, a conceptual definition of value-based reimbursement agreements was provided. These agreements serve as means to achieve both social and financial benefits on the healthcare system. Results: There is not a single, effective approach to achiev-ing payment reform. Payment reform is a strategic approach to restructuring the organization of the healthcare system in order to improve patient care. Successfully implementing payment reform results in significant cultural, social, and financial trans- formations. The stakeholders have agreed on the assertion that implementing value reimbursement systems and business mod-els might enhance efficiency and create social impact by miti-gating healthcare disparity and enhancing population health. Nevertheless, effectively executing these novel tactics has fi-nancial and societal hazards that need improved oversight from all parties involved. Utilizing state-of-the-art technology is cru-cial for effectively addressing these risks. However, it is also important to have strong leadership that prioritizes the goal of enhancing population health and, as a result, increasing value. Conclusion: Payment reform is used as a means to restruc-ture the organization of healthcare delivery to patients, with the aim of achieving social and financial changes in the healthcare system. | ||||
| Keywords | ||||
| Value-based reimbursement; Value-based health care; Review; Payment reform; Health policy | ||||
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