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Factors Influencing the Introduction of Value-Based Payment in Integrated Stroke Care: Evidence from a Qualitative Case Study

BACKGROUND: To address issues related to suboptimal insight in outcomes, fragmentation, and increasing costs, stakeholders are experimenting with value-based payment (VBP) models, aiming to facilitate high-value integrated care. However, insight in how, why and under what circumstances such models c...

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Autores principales: Salet, Newel, Buijck, Bianca I., van Dam-Nolen, Dianne H. K., Hazelzet, Jan A., Dippel, Diederik W. J., Grauwmeijer, Erik, Schut, F. T., Roozenbeek, Bob, Eijkenaar, Frank
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Ubiquity Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10437137/
https://www.ncbi.nlm.nih.gov/pubmed/37601033
http://dx.doi.org/10.5334/ijic.7566
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author Salet, Newel
Buijck, Bianca I.
van Dam-Nolen, Dianne H. K.
Hazelzet, Jan A.
Dippel, Diederik W. J.
Grauwmeijer, Erik
Schut, F. T.
Roozenbeek, Bob
Eijkenaar, Frank
author_facet Salet, Newel
Buijck, Bianca I.
van Dam-Nolen, Dianne H. K.
Hazelzet, Jan A.
Dippel, Diederik W. J.
Grauwmeijer, Erik
Schut, F. T.
Roozenbeek, Bob
Eijkenaar, Frank
author_sort Salet, Newel
collection PubMed
description BACKGROUND: To address issues related to suboptimal insight in outcomes, fragmentation, and increasing costs, stakeholders are experimenting with value-based payment (VBP) models, aiming to facilitate high-value integrated care. However, insight in how, why and under what circumstances such models can be successful is limited. Drawing upon realist evaluation principles, this study identifies context factors and associated mechanisms influencing the introduction of VBP in stroke care. METHODS: Existing knowledge on context-mechanism relations impacting the introduction of VBP programs (in real-world settings) was summarized from literature. These relations were then tested, refined, and expanded based on a case study comprising interviews with representatives from organizations involved in the introduction of a VBP model for integrated stroke care in Rotterdam, the Netherlands. RESULTS: Facilitating factors were pre-existing trust-based relations, shared dissatisfaction with the status quo, regulatory compatibility and simplicity of the payment contract, gradual introduction of down-side risk for providers, and involvement of a trusted third party for data management. Yet to be addressed barriers included friction between short- and long-term goals within and among organizations, unwillingness to forgo professional and organizational autonomy, discontinuity in resources, and limited access to real-time data for improving care delivery processes. CONCLUSIONS: Successful payment and delivery system reform require long-term commitment from all stakeholders stretching beyond the mere introduction of new models. Careful consideration of creating the ‘right’ contextual circumstances remains crucially important, which includes willingness among all involved providers to bear shared financial and clinical responsibility for the entire care chain, regardless of where care is provided.
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spelling pubmed-104371372023-08-19 Factors Influencing the Introduction of Value-Based Payment in Integrated Stroke Care: Evidence from a Qualitative Case Study Salet, Newel Buijck, Bianca I. van Dam-Nolen, Dianne H. K. Hazelzet, Jan A. Dippel, Diederik W. J. Grauwmeijer, Erik Schut, F. T. Roozenbeek, Bob Eijkenaar, Frank Int J Integr Care Integrated Care Case BACKGROUND: To address issues related to suboptimal insight in outcomes, fragmentation, and increasing costs, stakeholders are experimenting with value-based payment (VBP) models, aiming to facilitate high-value integrated care. However, insight in how, why and under what circumstances such models can be successful is limited. Drawing upon realist evaluation principles, this study identifies context factors and associated mechanisms influencing the introduction of VBP in stroke care. METHODS: Existing knowledge on context-mechanism relations impacting the introduction of VBP programs (in real-world settings) was summarized from literature. These relations were then tested, refined, and expanded based on a case study comprising interviews with representatives from organizations involved in the introduction of a VBP model for integrated stroke care in Rotterdam, the Netherlands. RESULTS: Facilitating factors were pre-existing trust-based relations, shared dissatisfaction with the status quo, regulatory compatibility and simplicity of the payment contract, gradual introduction of down-side risk for providers, and involvement of a trusted third party for data management. Yet to be addressed barriers included friction between short- and long-term goals within and among organizations, unwillingness to forgo professional and organizational autonomy, discontinuity in resources, and limited access to real-time data for improving care delivery processes. CONCLUSIONS: Successful payment and delivery system reform require long-term commitment from all stakeholders stretching beyond the mere introduction of new models. Careful consideration of creating the ‘right’ contextual circumstances remains crucially important, which includes willingness among all involved providers to bear shared financial and clinical responsibility for the entire care chain, regardless of where care is provided. Ubiquity Press 2023-08-10 /pmc/articles/PMC10437137/ /pubmed/37601033 http://dx.doi.org/10.5334/ijic.7566 Text en Copyright: © 2023 The Author(s) https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See http://creativecommons.org/licenses/by/4.0/.
spellingShingle Integrated Care Case
Salet, Newel
Buijck, Bianca I.
van Dam-Nolen, Dianne H. K.
Hazelzet, Jan A.
Dippel, Diederik W. J.
Grauwmeijer, Erik
Schut, F. T.
Roozenbeek, Bob
Eijkenaar, Frank
Factors Influencing the Introduction of Value-Based Payment in Integrated Stroke Care: Evidence from a Qualitative Case Study
title Factors Influencing the Introduction of Value-Based Payment in Integrated Stroke Care: Evidence from a Qualitative Case Study
title_full Factors Influencing the Introduction of Value-Based Payment in Integrated Stroke Care: Evidence from a Qualitative Case Study
title_fullStr Factors Influencing the Introduction of Value-Based Payment in Integrated Stroke Care: Evidence from a Qualitative Case Study
title_full_unstemmed Factors Influencing the Introduction of Value-Based Payment in Integrated Stroke Care: Evidence from a Qualitative Case Study
title_short Factors Influencing the Introduction of Value-Based Payment in Integrated Stroke Care: Evidence from a Qualitative Case Study
title_sort factors influencing the introduction of value-based payment in integrated stroke care: evidence from a qualitative case study
topic Integrated Care Case
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10437137/
https://www.ncbi.nlm.nih.gov/pubmed/37601033
http://dx.doi.org/10.5334/ijic.7566
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