Governments in Latin America and the Caribbean (LAC) are at various stages of provider payment reforms: from identifying needs and designing initial conceptual approaches to large-scale testing of innovative methods. There is now substantial technical guidance for policymakers on the incentives inherent in alternative provider payment mechanisms, and the theoretical advantages of new forms of payment such as capitation and case based payment. A singular focus on the technical aspects of provider payment reform, however, ignores a major element required to achieve results, i.e., the ability to manage the political environment surrounding payment reform efforts.
Implementing provider payment reform is inherently controversial and political. Provider payment reforms redistribute resources, resulting in real or perceived winners and losers. Policymakers’ failure to fully appreciate the consequences of provider payment reform for different stakeholders within the system and anticipate and plan for their reactions can lead to the failure of these reforms. This presentation will analyze provider payment reforms from the perspectives of three key agents within the health care system: providers, payors and consumers. It will examine how each of these groups is likely to experience provider payment reform and the anticipated reactions. This presentation will draw upon field experience in the LAC region and look at real life situations and examine the incremental changes and reactions of different stakeholders.
Learning Objectives: Learning objectives: At the conclusion of the session, the participants should be able to : 1.) Identify the characteristics of six major provider payment methods 2.) Describe the political ramifications of various provider payment reforms 3.) Discuss the reactions of providers, payors and consumers to provider payment reforms in health systems within the LAC region
Keywords: Health Reform, Policy/Policy Development
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.