Abstract

Introduction

Performance-based risk-sharing agreements (PBRSAs), between payers, health care providers, and technology manufacturers can be useful when there is uncertainty about the (cost-) effectiveness of a new technology or service. However, they can be challenging to design and implement.

Areas covered

A total of 18 performance-based agreements were identified through a literature review. All but 2 of the agreements identified were pay-for-performance schemes, agreed between providers and payers at the national level. No examples were found of agreements between healthcare providers and manufacturers at the local level. The potential for these local agreements was illustrated by hypothetical case studies of water quality management and an integrated chronic kidney disease programme.

Expert opinion

Performance-based risk-sharing agreements can work to the advantage of patients, health care providers, payers, and technology manufacturers, particularly if they facilitate the introduction of technologies or systems of care that might not have been introduced otherwise. However, the design, conduct, and implementation of PBRSAs in renal care pose a number of challenges. Efforts should be made to overcome these challenges, so that more renal care patients can benefit from technological advances and new models of care.

中文翻译：

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肾脏护理中基于绩效的风险分担协议：当前经验和未来前景

摘要

介绍

当不确定新技术或服务的（成本）有效性时，付款人，医疗保健提供者和技术制造商之间基于绩效的风险共享协议（PBRSA）可能会有用。但是，它们在设计和实现方面可能具有挑战性。

覆盖区域

通过文献综述，总共确定了18个基于绩效的协议。除2项协议外，所有协议都是按绩效付费计划，由提供方和付款方在国家一级商定。没有发现地方一级医疗保健提供者与制造商之间达成协议的例子。对水质管理的假设案例研究和综合性慢性肾脏病计划说明了这些地方协议的潜力。

专家意见

基于绩效的风险共享协议可以为患者，医疗保健提供者，付款人和技术制造商带来好处，特别是如果它们促进了本来不会引入的技术或医疗体系的引入。但是，PBRSA在肾脏护理中的设计，实施和实施带来了许多挑战。应该努力克服这些挑战，以便更多的肾脏护理患者可以从技术进步和新的护理模式中受益。