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 two 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 health care 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 program.

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

当新技术或服务的（成本）有效性不确定时，付款人、医疗保健提供者和技术制造商之间的基于绩效的风险分担协议 (PBRSA) 可能会很有用。但是，它们的设计和实施可能具有挑战性。

涵盖的领域

通过文献回顾，共确定了 18 项基于绩效的协议。除两项已确定的协议外，所有协议都是按绩效付费的计划，由供应商和付款人在国家层面达成一致。没有发现地方一级医疗保健提供者和制造商之间达成协议的例子。假设的水质管理案例研究和综合慢性肾病项目说明了这些地方协议的潜力。

专家意见

基于绩效的风险分担协议可以使患者、医疗保健提供者、付款人和技术制造商受益，特别是如果它们有助于引入原本可能不会引入的技术或护理系统。然而，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能够从技术进步和新的护理模式中受益。