Simplification of patient cost sharing: the example of physician consultations and visits
Farfan-Portet M-I, Devos C, Devriese S, Cleemput I, Van de Voorde C
Record ID 32014001283
English
Authors' recommendations:
The succession of reforms of patient cost sharing for consultations and home visits of GPs and for specialist consultations has resulted in a multitude of different amounts which are calculated in many different ways.
There are several ways to simplify the current complex structure. For example, removing differences in cost sharing according to GP qualification or patient residence is a relatively small and inexpensive reform for GP home visits. Other options are more fundamental and often also more expensive for RIZIV/INAMI of for certain patient groups.
To avoid that also in the future patient cost sharing will be determined in an ad hoc way, applying principles and objectives for defining the level and distribution of cost sharing might be a useful first step. If patient cost
sharing is meant to give financial incentives and to steer patients towards particular services, then co-payments are more transparent than coinsurance rates. Moreover, co-payments have the advantage that they are easier to work with in a (social) third-party payer system because one can easily round them off.
In addition to transparency, also coherence can be aimed at when simplifying the structure of co-payments and coinsurance rates. Applying the same level of cost sharing, irrespective of GP qualification or patient
residence are straightforward measures.
Recent decisions of the National Commission Physicians-Sickness Funds seem to go in that direction, but they are not yet translated into regulation.
Details
Project Status:
Completed
Year Published:
2012
URL for published report:
http://kce.fgov.be/sites/default/files/page_documents/KCE_180C_simplification_patient_cost_sharing_second%20print.pdf
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
Belgium
MeSH Terms
- Episode of Care
- Referral and Consultation
- Family Practice
Contact
Organisation Name:
Belgian Health Care Knowledge Centre
Contact Address:
Administrative Centre Botanique, Doorbuilding (10th floor), Boulevard du Jardin Botanique 55, B-1000 Brussels, Belgium tel: +32 2 287 33 88 fax: +32 2 287 33 85
Contact Name:
info@kce.fgov.be
Contact Email:
info@kce.fgov.be
Copyright:
Belgian Health Care Knowledge Centre (KCE)
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