DRG + Australia, The case mix In Portugal the case-mix adjusted Budget Czech, adjusted component of each hospital budget has Denmark, budget will been increased; the implementation of Germany, improve the model started in 1997 as 10% Hungary, accessibility of DRG- based and reached 50% in fiscal Italy, New services. year 2002. Zealand, Norway FFS + Budget Czech, The tendency Since 2000 in Netherland, hospital Hungary, of financing efforts have been undertaken Netherlands, overprovision to integrate the fee-for-service system Poland of services for specialists and the hospital budget under FFS can system into a single integrated budget. be capped by limits of price or volume. However, reforms in the OECD countries demonstrated a movement towards the simultaneous use of different provider payment mechanisms, in other words paying the same provider in different ways. Some reform experiences with mixed provider payment mechanisms in the OECD countries are elaborated in Table 2 on the previous page. Table 3 provides an overview of purchasers and applied provider payment mechanisms by type of health care providers in Vietnam. The provider payment mechanisms arrangements vary depending on type of a health care provider. The purchasing arrangement for public health care providers is more diverse than for private health care providers that are usually reimbursed on FFS basis. Table 3. Purchasers and provider payment mechanisms by type of a provider in Vietnam PURCHASER PROVIDER MoH PPC/DoF/DoH Other VSS PSS Households Ministries Central Budgetary FSS FSS FSS Hospital transfers Provincial Budgetary FSS FSS Hospital transfers Provincial Budgetary FSS Preventive transfers Centre District Budgetary FSS FSS Hospital transfers District Budgetary FSS
DRG + Budget Australia, Czech, Denmark, Germany, Hungary, Italy, New Zealand, Norway The case mix adjusted budget will improve accessibility of services. In Portugal the case-mix adjusted component of each hospital budget has been increased; the implementation of the model started in 1997 as 10% DRG- based and reached 50% in fiscal year 2002. FFS + Budget Czech, Hungary, Netherlands, Poland The tendency of overprovision of services under FFS can be capped by limits of price or volume. Since 2000 in Netherland, hospital financing efforts have been undertaken to integrate the fee-for-service system for specialists and the hospital budget system into a single integrated budget. However, reforms in the OECD countries demonstrated a movement towards the simultaneous use of different provider payment mechanisms, in other words paying the same provider in different ways. Some reform experiences with mixed provider payment mechanisms in the OECD countries are elaborated in Table 2 on the previous page. Table 3 provides an overview of purchasers and applied provider payment mechanisms by type of health care providers in Vietnam. The provider payment mechanisms arrangements vary depending on type of a health care provider. The purchasing arrangement for public health care providers is more diverse than for private health care providers that are usually reimbursed on FFS basis. Table 3. Purchasers and provider payment mechanisms by type of a provider in Vietnam PROVIDER PURCHASER MoH PPC/DoF/DoH Other Ministries VSS PSS Households Central Hospital Budgetary transfers FSS FSS FSS Provincial Hospital Budgetary transfers FSS FSS Provincial Preventive Centre Budgetary transfers FSS District Hospital Budgetary transfers FSS FSS District Budgetary FSS
9.%20Report%20on%20PPM%20mix%20EN.docx