KCE has published a study with recommendations on the new financing methodology suggested by the Ministry of Health
In the last few years, the Belgian Ministry of Health has been developing possible reforms to improve the effectiveness and efficiency of healthcare financing in the country, particularly with regards to financing of inpatient care services.
The new financing reform proposed by the Ministry envisages three different payment methods based on three clusters of healthcare variability in hospital admissions. A low variability cluster will include hospitalizations that only require standard care, with low variability from one patient to another and high predictability. These stays would be funded prospectively, via a lump sum per admission, regardless of the services actually delivered.
A medium variability cluster will include hospitalization requiring more variable care. The proposed funding system is similar to the one currently in effect: a fixed national budget distributed on the basis of the "case mix" (number and type of patients) of each hospital.
A highly variable cluster for episodes where needs in terms of services of care are difficult to standardize and therefore unpredictable. In this cluster, care is delivered tailored to the needs of patients and hospitals will be reimbursed based on the so-called principle of justified care delivered.
The Belgian Healthcare Knowledge Center (KCE) has been requested to analyze the international experience in order to provide recommendations for the implementation of the financing reform, particularly with regards to the financing of episodes of care characterized by high variability.
KCE concluded that it is not possible to draft recommendations on the adjustment of financing of high variability healthcare based on international experience. This is due to the fact that considered foreign healthcare systems refer to national cost data to inform decisions of financing of specialized healthcare groups and to analyse differences between and within different high variability groups. Belgium does not have a unique national cost reporting system in place yet. In the absence of a national information system that allows standardized reporting of costs in the country, KCE recommends referring to cost information collected on a voluntary basis by single hospitals and clinics and to consider expanding this experience to other key providers in the country.