Pay for Quality

116 Pay for Quality KCE Reports 118
Table 10: Breast cancer screening prevention bonus
IV. BREAST CANCER SCREENING PREVENTION BONUS
Initiated by Regional Flemish government in cooperation with Logo
ZuiderKempen (area) and the University of Antwerp
Overall objective This geographically sampled demonstration project, with a
concurrent control area, investigates whether the use of a
prevention bonus leads to an increase in patient participation in
the screening of breast cancer.
Date of implementation in Belgium 2009-2010
Target audience General practitioners and gynaecologists.
Content The positive financial incentive is as such the main focus of this
project. The incentive should reinforce the degree of advice and
motivation to participate in screening, as supported by providers,
towards women between 50 and 69 years of age.
Primary focus (structure, process, Process
outcome)
Type of indicators used (if any) Mammography use is expressed in terms of the patient
participation rate.
Purpose of indicators used To evaluate the effect of the use of a financial incentive
Type of incentives A financial reward is awarded if the area participation rate
increases with at least 2.5% (stimulation of cooperative team
approach). The bonus size is determined by the participation
effect size (2 to 8 euro for an effect of respectively 2.5 to 10% or
more). The bonus is awarded to the practice of the provider for
each patient that participated in screening. The time interval of
incentive provision is two years and a one time event.
Results (if available) Not available
Sources (most relevant ones) Not available
Total budget Depends on project results (level of pay-out), max. €212 000
Table 11: Capitation funding revaluation in the primary health care centres
V. CAPITATION FUNDING REVALUATION IN THE PRIMARY HEALTH CARE
CENTRES
Initiated by French- and Dutch-speaking federations of “Maisons médicales”
and “Wijkgezondheidscentra”, who asked the National Institute
for Health and Disability Insurance (NIHDI) (INAMI/RIZIV) for
the revaluation.
Overall objective To contain costs due to overuse
Date of implementation in Belgium 1992
Target audience Care providers (GPs, nurses, physiotherapists) who concluded a
capitation fee contract with the legal health insurers.
Content Money saving in referral in 3 domains (hospitalization, medical
imaging and clinical/ medical Biology), compared to the national
level, is granted by an increased capitation fee.
Primary focus (structure, process, The focus is on processes, and on financial outcomes.
outcome)
Type of indicators used (if any) The global saving for the insurance within the 3 domains cited
above, considered as a whole, is the only economic indicator. A
cost overrun within one domain can be balanced by money saving
within another.
The indicators were yearly measured during the first years, but
no more currently. The latest published assessment was part of
the KCE report 85, made on 2002, 2003 and 2004 data. 248
Purpose of indicators used The purpose is to support a rational use of medical imaging and
clinical/medical biology, and second line care in general. The
programme tries to support the role of GPs to reduce the
duration of hospital stay of their inpatients.
Type of incentives A 10% revaluation of the capitation fee.