Innovative forms of value-based purchasing contracts, based on outcome instead of volume, are imperative to face the imminent cost crisis in health care. The objective of this study was to design and implement a model for an outcome-based purchasing contract between a hospital and a health insurance company. The model was implemented in 2015. A study cohort (n = 14,944) from patients with coronary artery disease or atrial fibrillation treated in 2014 was compared to a historical reference cohort from patients treated between 2010 and 2013. The outcome measures and the model are based on Porter's value-based healthcare principles. Improvements in outcomes were observed, leading to a financial incentive to be spent on further quality improvement. Implementation of this model is a first step towards enabling inclusion of patient-relevant outcomes in purchasing for healthcare. It aligns the focus of health insurance companies and hospitals on patient value.

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International Journal of Healthcare Management
Erasmus University Rotterdam

van Veghel, D. (D.), Schulz, D.N. (D. N.), van Straten, A.H.M, Simmers, T.A. (T. A.), Lenssen, A. (A.), Kuijten-Slegers, L. (L.), … Dekker, L.R.C. (2018). Health insurance outcome-based purchasing. International Journal of Healthcare Management, 1–8. doi:10.1080/20479700.2018.1458177