Effects of mixed provider payment systems and aligned cost sharing practices on expenditure growth management, efficiency, and equity: a structured review of the literature

Feldhaus, Isabelle; Mathauer, Inke

doi:10.1186/s12913-018-3779-1

Table 3 Summary of reviewed articles reporting effects on health expenditure growth, efficiency, and equity

From: Effects of mixed provider payment systems and aligned cost sharing practices on expenditure growth management, efficiency, and equity: a structured review of the literature

Article					Effects			Author
Country	Year	Type of provider payment mix	Methods	Data	HE growth	Efficiency	Equity	Author
Australia	2015	Cost sharing (rebates)	Qualitative analysis	In-depth patient interviews			+	Foster & Mitchell [57]
Australia	2015	FFS-PFC blended payment	Qualitative analysis	In-depth patient interviews			+	Foster & Mitchell [57]
Austria, Denmark, France, Germany	2016	FFS-PFC blended payment	Difference-in-differences analysis	Panel cost data	0			Tsiachristas et al. [27]
Austria, Germany	2012	FFS-PFC blended payment	Case study	Published literature, DISMEVAL project	+	+ / 0		Nolte et al. [47]
Belgium, Italy, Japan, Netherlands, Sweden, Taiwan, United Kingdom, United States	2012	Bundled payment	Systematic review	Published literature	+ (hospital, ambulatory)- (outpatient, post-acute)	+		Hussey et al. [19]
Canada	2011	CAP-PFP blended payment	Policy analysis	Published literature, semi-structured interviews with observers		+	+	Hutchison et al. [31]
Canada	2011	FFS-PFP blended payment	Policy analysis			+		Hutchison et al. [31]
Canada	2015	FFS-CAP blended payment	Nonlinear regression model	Population-based administrative records			+	Kiran et al. [33]
Canada	2015	FFS-PFP blended payment	Cost analysis with propensity score matching	Administrative records of costs and utilization by disease group	+ / -	+		Hollander & Kadlec [28]
China	2010	FFS-CAP blended payment	Systematic review	Published literature, official documents	0			Yip et al. [26]
China	2010	Pay-for-performance	Systematic review	Published literature, official documents	+			Yip et al. [26]
Estonia, Portugal, United Kingdom	2016	CAP-PFP blended payment	Difference-in-differences analysis	Panel cost data	+ (administrative, hospital)			Tsiachristas et al. [27]
France	2016	FFS-PFP blended payment	Difference-in-differences analysis	Panel cost data	+ (administrative, hospital)			Tsiachristas et al. [27]
Germany	2010	Pay-for-coordination	Multivariate regression analysis	Cohort study of type 2 diabetes patients		+		Schafer et al. [67]
Germany	2010	Pay-for-coordination	Cost analysis with propensity score matching	Insurance claims records	+	+		Stock et al. [68]
Germany, Netherlands	2016	Bundled payment	Difference-in-differences analysis	Panel cost data	+ (outpatient)			Tsiachristas et al. [27]
Hungary	2016	CAP-PFC blended payment	Difference-in-differences analysis	Panel cost data	0			Tsiachristas et al. [27]
Netherlands	2012	Disease-based bundled payment	Case study	Published literature, DISMEVAL project	0			Nolte et al. [47]
Netherlands	2012	Disease-based bundled payment	Multilevel, random effects meta-analysis model	Individual patient data on performance indicators of processes and outcomes, DISMEVAL project		+		Elissen et al. [69]
Netherlands	2013	Disease-based bundled payment	Case study	Published literature, official documents	+	+		Froimson et al. [39]
Netherlands	2013	Disease-based bundled payment	Qualitative analysis	Semi-structured interviews with providers		+ / -		Raaijmakers et al. [70]
Netherlands, Germany	2014	Disease-based bundled payment	Case study	Published literature, expert interviews	–			Busse & Stahl [56]
Netherlands, Germany	2014	Shared savings	Case study	Published literature, expert interviews	+			Busse & Stahl [56]
Thailand	2015	FFS-CAP blended payment	Document review	Official and grey documents, published literature	+	+	+	Tangcharoensathien et al. [24]
United Kingdom	2009	Pay-for-performance	Multivariate logistic regression analysis	Cross-sectional surveys		+	+	Millett et al. [71]
United States	1995	Episode-based bundled payment	Case study	Narrative	+			Edmonds & Hallman [36]
United States	2007	Pay-for-performance	Descriptive analysis	Aggregated patient data	+	+		Casale et al. [72]
United States	2012	Pay-for-coordination	Systematic review	Peer-reviewed studies, published reports	+			Basu et al. [73]
United States	2013	Episode-based bundled payment	Case study	Document review	0			Chambers et al. [45]
United States	2014	Bundled payment (varied)	Issue brief	Document review	+	+		Bachrach et al. [34]
United States	2014	Episode-based bundled payment	Budget impact model	Cost data from the US Renal Data System	+			Liu et al. [42]
United States	2015	Episode-based bundled payment	Case study	Patient episode data	+	+		Doran & Zabinski [37]
United States	2015	Episode-based bundled payment	Experimental comparison study	Claims data	+	+		Froemke et al. [38]
United States	2015	Episode-based bundled payment	Case study	Claims data		+		Iorio [52]
United States	2015	Episode-based bundled payment	Comparative descriptive analysis	Acute care hospital participant data	0			Tsai et al. [48]
United States	2015	Episode-based bundled payment	Descriptive analysis	Patient and claims data, routine quality metrics	+ / 0	+		Whitcomb et al. [49]
United States	2015	Gainsharing	Experimental comparison study	Claims data	+	+		Froemke et al. [38]
United States	2015	Episode-based bundled payment	Case study	Narrative	+	+		Wagner [44]
		Pay-for-performance			+	+
		Shared savings			+	+
United States	2015	Shared savings	Case study	Narrative	+	+		Kuhn & Lehn [55]
United States	2016	Episode-based bundled payment	Descriptive analysis	Patient episode data	+	+		Bolz & Iorio [35]
United States	2016	Episode-based bundled payment	Experimental comparison study	Individual patient and episode reimbursement data	0	+		Courtney et al. [46]
United States	2016	Episode-based bundled payment	Case study	Narrative		+		Curry & Fee [50]
United States	2016	Episode-based bundled payment	Descriptive analysis	Medicare patient data	+	+		Iorio et al. [40]
United States	2016	Episode-based bundled payment	Cohort cost identification study	Insurance and commercial claims data	+ / 0			Kirby et al. [41]
United States	2016	Episode-based bundled payment	Issue brief	Narrative	+	+		Porter & Kaplan [43]
United States	2016	Episode-based bundled payment	Decision model with sensitivity analysis	Bundled payment claims data for patients discharged to rehabilitation and home		+		Slover et al. [53]
United States	2016	Patient-based bundled payment	Conceptual framework development synthesizing experiences from 6 cases	Published literature, official documents		+		Conrad et al. [51]
United States	2016	Shared savings		Published literature, official documents		+		Conrad et al. [51]

Note: (+) indicates improvements in indicator; (−) indicates worsening of indicator; (−/+) indicates mixed results; (0) indicates no changes and/or unclear findings; (+/0) indicates improvements reported, but with uncertain attribution to payment model of interest; empty indicates that this aspect was not studied. CAP = capitation; DRGs = diagnosis-related groups; EHR = electronic health record; FFS = fee-for-service; HE = health expenditure; PFC = pay-for-coordination; PFP = pay-for-performance

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