2iM Inteligência Médica

Value-Based
Payment
Models

2iM platforms are prepared to support your institution in the implementation of new Value-based remuneration models.

Modelos de Pagamento Baseado em Valor

Compensation models determine the logic, process and cost of assistance

The need to rethink the remuneration models is imperative for better delivery of Value to patients and, therefore, for the sustainability of the health system, be it public or private.

We start from the premise that the modality and dynamics of the remuneration of health service providers are the main vector that directs and determines the logic, process and cost of assistance.

Thus, it is not possible to think of Value-based healthcare without having associated new logics in the remuneration model.

Associate traditional performance with an additional performance or Value

Any Value-based remuneration model must have a part conditional on the Value delivered. However, the great challenge of current models is the methodological difficulty of measuring this Value.

The 2iM.Analytics platform uses the HVS – Health Value Score (Abicalaffe, 2015) methodology for an adequate and fair measurement.

2iM is prepared to support your institution in the implementation of new value-based remuneration models. The 2iM.Analytics platform can be contracted with or without implementation advice.

The remuneration models that can be implemented, in a limited way, are the following:

• Pay-for-Performance

Payment for Episodes or Lines of Care (Bundle Payments)

Partial or Global Capitation Payment (Capitation Payment)

Payment by Adjusted Global Budget (Global Budget Payment)

Comparison between models

In the table below you can see the strengths or attention points of each model, the
application profiles and the implementation complexities.

PAY-FOR-PERFORMANCE (P4P) PAYMENT FOR EPISODES (BUNDLE) PAYMENT BY ADJUSTED GLOBAL BUDGET PAYMENT BY CAPITATION (CAPITATION)
Payment System
Retrospective
Retrospective
Prospective
Prospective
Recommended Profile
Accredited network, cooperative doctors and contracted professionals.
Lines of care, clinical conditions and/or procedure of high prevalence and low variability.
Hospitals with a high volume history.
Primary care and some specialties.
Ease of Deployment
++++
+
++
+++
Strong points
Ease of deployment.
Competition for Value.
Predictability and efficiency.
Population health management.
Weak Points (without VBHC)
Volume and complexity.
Undertreatment, risk selection and interoperability.
Undertreatment, risk selection and does not promote competition.
Undertreatment, risk selection.

Get to know more specifics
of each model

Pay-for-Performance

Payment for Episodes or Lines of Care (Bundle Payments)

Payment by Global Adjusted Budget (Global Budget Payment)

Payment by Capitation Partial or Global (capitation Payment)