Why and how did Israel adopt activity-based hospital payment? The Procedure-Related Group incremental reform

dc.contributor.authorBrammli-Greenberg, Shuli
dc.contributor.authorWaitzberg, Ruth
dc.contributor.authorPerman, Vadim
dc.contributor.authorGamzu, Ronni
dc.date.accessioned2018-07-27T11:37:40Z
dc.date.available2018-07-27T11:37:40Z
dc.date.issued2016-09-01
dc.description.abstractHistorically, Israel paid its non-profit hospitals on a perdiem (PD) basis. Recently, like other OECD countries, Israel has moved to activity-based payments. While most countries have adopted a diagnostic related group (DRG) payment system, Israel has chosen a Procedure-Related Group (PRG) system. This differs from the DRG system because it classifies patients by procedure rather than diagnosis. In Israel, the PRG system was found to be more feasible given the lack of data and information needed in the DRG classification system. The Ministry of Health (MoH) chose a payment scheme that depends only on inhouse creation of PRG codes and costing, thus avoiding dependence on hospital data. The PRG tariffs are priced by a joint Health and Finance Ministry commission and updated periodically. Moreover, PRGs are believed to achieve the same main efficiency objectives as DRGs: increasing the volume of activity, shortening unnecessary hospitalization days, and reducing the gaps between the costs and prices of activities. The PRG system is being adopted through an incremental reform that started in 2002 and was accelerated in 2010. The Israeli MoH involved the main players in the hospital market in the consolidation of this potentially controversial reform in order to avoid opposition. The reform was implemented incrementally in order to preserve the balance of resource allocation and overall expenditures of the system, thus becoming budget neutral. Yet, as long as gaps remain between marginal costs and prices of procedures, PRGs will not attain all their objectives. Moreover, it is still crucial to refine PRG rates to reflect the severity of cases, in order to tackle incentives for selection of patients within each procedure.en
dc.identifier.issn0168-8510
dc.identifier.urihttps://depositonce.tu-berlin.de/handle/11303/8041
dc.identifier.urihttp://dx.doi.org/10.14279/depositonce-7205
dc.language.isoenen
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/en
dc.subject.ddc610 Medizin und Gesundheitde
dc.subject.otherhospital paymentsen
dc.subject.otherdiagnostic-related groupen
dc.subject.otherDRGen
dc.subject.otheractivity-based paymentsen
dc.subject.otherhealth policy reformen
dc.subject.otherpayment reformen
dc.subject.otherhealth economicsen
dc.titleWhy and how did Israel adopt activity-based hospital payment? The Procedure-Related Group incremental reformen
dc.typeArticleen
dc.type.versionpublishedVersionen
dcterms.bibliographicCitation.doi10.1016/j.healthpol.2016.08.008en
dcterms.bibliographicCitation.issue10en
dcterms.bibliographicCitation.journaltitleHealth Policyen
dcterms.bibliographicCitation.originalpublishernameElsevieren
dcterms.bibliographicCitation.originalpublisherplaceAmsterdamen
dcterms.bibliographicCitation.pageend1176en
dcterms.bibliographicCitation.pagestart1171en
dcterms.bibliographicCitation.volume120en
tub.accessrights.dnbfreeen
tub.affiliationFak. 7 Wirtschaft und Management::Inst. Technologie und Management (ITM)::FG Management im Gesundheitswesende
tub.affiliation.facultyFak. 7 Wirtschaft und Managementde
tub.affiliation.groupFG Management im Gesundheitswesende
tub.affiliation.instituteInst. Technologie und Management (ITM)de
tub.publisher.universityorinstitutionTechnische Universität Berlinen

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