Publication:
How to Pay? Understanding and Using Incentives

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dc.contributor.authorLangenbrunner, John C.
dc.contributor.authorXingzhu, Liu
dc.date.accessioned2013-05-30T14:28:47Z
dc.date.available2013-05-30T14:28:47Z
dc.date.issued2004-09
dc.description.abstractMany countries have experimented with alternative ways of paying providers of health care services. This paper illustrates different methods, suggests some of the theoretic advantages and limitations of each, and provides a general theoretical framework for evaluating alternatives. Over the last two decades, new and more sophisticated payment systems have evolved, with a broadening of units of payment and setting of payments prospectively. The authors discuss the international experience of a number of payment systems, both traditional and more recently developed, including line-item budgeting, salary, fee-for-service, per diem, case-mix adjusted per episode, global budgets and capitation. The authors argue that no one set of incentives will address the multiple objectives of purchasers, providers, and patients. As a result, purchasers and policymakers must understand and address policy objectives explicitly. With more sophisticated systems, part or all of the financial risk is transferred from the purchaser back to the provider and patient. Most observers caution against full risk but encourage some supply-side cost sharing only, with purchaser and provider sharing in risk arrangements to address moral hazard issues. Imposing high copayments or user fees is an alternative, but in developing countries that quickly erodes financial protection. More sophisticated payment systems may also lead to higher transaction costs and necessitate a greater capacity to use information and management systems. Finally, the best planned and implemented payment incentives and systems may fail due to a variety of other and related factors in health care delivery. Unless these issues are addressed, impacts of change in resource allocation and purchasing will be diluted or neutralized. Technicians and policymakers will need to address these potential "chokepoints" in any process of implementation and refinement.en
dc.identifierhttp://documents.worldbank.org/curated/en/2004/09/5643905/pay-understanding-using-incentives
dc.identifier.doi10.1596/13674
dc.identifier.urihttps://hdl.handle.net/10986/13674
dc.languageEnglish
dc.language.isoen_US
dc.publisherWorld Bank, Washington, DC
dc.relation.ispartofseriesHealth, Nutrition and Population (HNP) discussion paper;
dc.rightsCC BY 3.0 IGO
dc.rights.holderWorld Bank
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/igo/
dc.subjectADVERSE SELECTION
dc.subjectALLOCATIVE EFFICIENCY
dc.subjectBANK PUBLICATIONS
dc.subjectBEDS
dc.subjectCAPITATION
dc.subjectCHILD HEALTH
dc.subjectCHILD HEALTH SERVICES
dc.subjectCIVIL SERVANTS
dc.subjectCLINICAL OUTCOMES
dc.subjectCLINICS
dc.subjectCOST SHIFTING
dc.subjectDISABILITY
dc.subjectDISCHARGE
dc.subjectDISPENSARIES
dc.subjectDOCTORS
dc.subjectDRAFTS
dc.subjectECONOMICS
dc.subjectEMPLOYMENT
dc.subjectENVIRONMENTAL DEGRADATION
dc.subjectETHICS
dc.subjectEXPENDITURES
dc.subjectFAMILY PHYSICIANS
dc.subjectFEE FOR SERVICE
dc.subjectFINANCIAL RISK
dc.subjectGENERAL PRACTITIONERS
dc.subjectGLOBAL BUDGETS
dc.subjectHEALTH CARE
dc.subjectHEALTH CARE COSTS
dc.subjectHEALTH CARE DELIVERY
dc.subjectHEALTH CARE FINANCING
dc.subjectHEALTH CARE PROVIDERS
dc.subjectHEALTH CARE SERVICES
dc.subjectHEALTH CARE SYSTEMS
dc.subjectHEALTH CENTERS
dc.subjectHEALTH EXPENDITURE
dc.subjectHEALTH FACILITIES
dc.subjectHEALTH INSTITUTIONS
dc.subjectHEALTH INSURANCE
dc.subjectHEALTH INTERVENTIONS
dc.subjectHEALTH NEEDS
dc.subjectHEALTH OUTCOMES
dc.subjectHEALTH PROVIDERS
dc.subjectHEALTH SECTOR
dc.subjectHEALTH SERVICE PROVISION
dc.subjectHEALTH SERVICES
dc.subjectHEALTH SYSTEM
dc.subjectHEALTH SYSTEMS
dc.subjectHOSPITAL CARE
dc.subjectHOSPITAL COSTS
dc.subjectHOSPITAL SERVICES
dc.subjectHOSPITALS
dc.subjectHUMAN DEVELOPMENT
dc.subjectHUMAN RESOURCES
dc.subjectIMMUNIZATION
dc.subjectIMMUNIZATION COVERAGE
dc.subjectINCOME
dc.subjectINPATIENT CARE
dc.subjectINSURANCE COMPANIES
dc.subjectINSURERS
dc.subjectINTEGRATION
dc.subjectLATIN AMERICAN
dc.subjectLESSONS LEARNED
dc.subjectLOW-INCOME COUNTRIES
dc.subjectMALNUTRITION
dc.subjectMANAGED CARE
dc.subjectMANAGERS
dc.subjectMARGINAL COSTS
dc.subjectMEDICAL CARE
dc.subjectMEDICAL EQUIPMENT
dc.subjectMEDICAL PERSONNEL
dc.subjectMORAL HAZARD
dc.subjectNONGOVERNMENTAL ORGANIZATIONS
dc.subjectNURSES
dc.subjectNURSING
dc.subjectNURSING HOME CARE
dc.subjectNURSING HOMES
dc.subjectNUTRITION
dc.subjectOUTPATIENT CARE
dc.subjectOUTPATIENT SERVICES
dc.subjectOVERRUNS
dc.subjectPATIENTS
dc.subjectPAYMENT SYSTEMS
dc.subjectPHYSICIANS
dc.subjectPREGNANT WOMEN
dc.subjectPRIMARY CARE
dc.subjectPROMOTING HEALTH
dc.subjectPUBLIC HOSPITALS
dc.subjectPUBLIC SECTOR
dc.subjectPUBLIC SPENDING
dc.subjectQUALITY OF CARE
dc.subjectRESOURCE ALLOCATION
dc.subjectRURAL HOSPITALS
dc.subjectSERVICE DELIVERY
dc.subjectSOCIAL INSURANCE
dc.subjectSOUTH AMERICAN
dc.subjectSUPPLIERS
dc.subjectSURGERY
dc.subjectWORKING ENVIRONMENT
dc.titleHow to Pay? Understanding and Using Incentivesen
dspace.entity.typePublication
okr.date.doiregistration2025-05-05T11:48:16.096822Z
okr.doctypePublications & Research::Working Paper
okr.doctypePublications & Research
okr.docurlhttp://documents.worldbank.org/curated/en/2004/09/5643905/pay-understanding-using-incentives
okr.guid639231468762613437
okr.identifier.externaldocumentum000090341_20050307132123
okr.identifier.internaldocumentum5643905
okr.identifier.report31633
okr.language.supporteden
okr.pdfurlhttp://www-wds.worldbank.org/external/default/WDSContentServer/WDSP/IB/2005/03/07/000090341_20050307132123/Rendered/PDF/316330HNP0LangenbrunnerCh5HowtoPayFinal.pdfen
okr.topicHealth Monitoring and Evaluation
okr.topicHealth Systems Development and Reform
okr.topicEnvironmental Economics and Policies
okr.topicHealth Economics and Finance
okr.topicPayment Systems and Infrastructure
okr.unitECSHD
okr.volume1 of 1
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