Health care provider payment schemes and their changes since 2010 across nine Central and Eastern European countries – a comparative analysis

Costase Ndayishimiye, Marzena Tambor, Daiga Behmane, Antoniya Dimova, Alina Dūdele, Aleksandar Džakula, Barbora Erasti, Péter Gaál, Triin Habicht, Pavel Hroboň, Liubove Murauskienė, Tamás Palicz, Silvia Gabriela Scîntee, Lenka Šlegerová, Cristian Vladescu and Katarzyna Dubas-Jakóbczyk

Health Policy, 2025, vol. 153, issue C

Abstract: Health care provider payment schemes consist of a complex set of arrangements used to influence provider behavior towards specific health policy objectives. The study aimed at: 1) providing a structured, comparative overview of current payment schemes within the public health system in selected Central and Eastern European (CEE) countries for different health care providers; 2) identifying and comparing major changes in payment schemes since 2010. Methods included: 1) data collection form development; 2) desk research; 3) national experts’ consultations; 4) comparative analysis. The results indicate that the nine CEE countries (Bulgaria, Croatia, Czechia, Estonia, Latvia, Lithuania, Hungary, Poland, and Romania) show numerous similarities in provider payment method mix and in the general direction of the recent changes conducted in this field. Output-based payment methods prevail across all countries and types of providers. Primary health care (PHC) providers are characterized by the most diverse payment method mix. PHC and hospital inpatient care have experienced the most frequent changes in their payment schemes within the last 13 years. These focused mostly on modifying existing payment methods (e.g. detailing payment categories), and applying additional methods to pay for specific services or performance (e.g. fee-for-service, bonus payments). The objectives of conducted change were often similar, thus, there is high potential for a shared, cross-country learning.

Keywords: Provider payment scheme; Provider payment method; Health care provider; Central and Eastern Europe (search for similar items in EconPapers)
Date: 2025
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Persistent link: https://EconPapers.repec.org/RePEc:eee:hepoli:v:153:y:2025:i:c:s016885102500017x

DOI: 10.1016/j.healthpol.2025.105261

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