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Table 1 The potential of monetary incentives in cost-containment policies

From: Provider payments and patient charges as policy tools for cost-containment: How successful are they in high-income countries?

Cost-containment instrument Incentive directed at Relevant category of care Potential for cost-containment Additional comments
Fee-for-service Providers Outpatient and inpatient care Low • The upward effect of fees on costs can be neutralized, when hard budgets are introduced • The structure and level of fees in the FFS schedule can be changed for cost-containment purposes.
Per diem payment Providers Inpatient care Low The upward effect of per diem payments on hospital costs can be neutralized, when hard hospital budgets are introduced
Case payment Providers Inpatient and outpatient care Medium The net effect on cost-containment may be reduced by cost-shifting to other health sectors
Capitation Providers Inpatient and outpatient care Medium The net effect on cost-containment may be reduced by cost-shifting to other health sectors
Salaries Providers Inpatient and outpatient care (worktime of providers only) High The overall on cost-containment of national health expenditure depends on provider payment mechanisms introduced for other types of care
Budgets Providers Inpatient and outpatient care High • The cost-containment efficiency of budgets is low, when budgets are 'soft' • Cost-shifting between sectors may reduce the overall cost-containment potential
Patient charges Patients Inpatient and outpatient care Low Cost-reductions may be seen with important increases in patient charges, combined with the existence of medium to high price sensitivity
Reference price system Patients Pharmaceuticals Medium Cost-containment potential will be low, when prescribing of drugs outside the reference-price system remains important