Publications & Documents

The Menzis Shared Savings Program was initiated in 2014 by the Dutch insurer Menzis and the national primary care organisation Arts en Zorg, and is among the first value-based payment models for primary care in Europe. It runs as a complement to the current – volume-driven – primary care payment system. This paper reviews the evidence of the impact of this programme against its stated objectives. The Menzis Shared Savings Program led to a lower volume of care, particularly in terms of referrals to specialist care, laboratory care and general practitioners care. Main facilitating factors were the advanced data infrastructure in place, communication and transparency about the programme’s parameters, and the programme’s focus on mitigating financial risk and uncertainty for providers. Shared savings models – even when added as a mere complement to existing volume-driven payment methods – could enhance value in health systems.

The Health System Performance Assessment (HSPA) framework for Estonia acts as a tool for stakeholders and policy makers to guide health reforms in an evidence-based and targeted manner. This report outlines the Estonian HSPA framework and documents its development through a highly inclusive and consultative process. It also reports on indicators that were selected to populate the first Estonian HSPA report, their selection criteria and core methodologies, and describes the HSPA governance structure, implementation plan, and HSPA capacity building. The report provides a guideline to embed the HSPA in Estonian governance processes in a sustainable manner. Implementing the HSPA will improve systematised public reporting on the health system performance in Estonia, thus increasing transparency and accountability of stakeholders and public awareness and involvement in the health system policy making.

The 2018 OECD report Pharmaceutical Innovation and Access to Medicines noted that fostering competition in both on- and off-patent markets can improve the efficiency of pharmaceutical spending. Various policies are used to promote competition among off-patent medicines, but generally do not induce competition in on-patent markets. While tendering is widely used for hospital and other institutional purchasing, it is less common for ambulatory care medicines, or where medicines are reimbursed rather than supplied directly. As part of its broader work agenda on 'Increasing the transparency of pharmaceutical markets to inform policies', this paper explores how payers could harness competition to improve the efficiency of spending on medicines still subject to patent protection or regulatory exclusivity. The OECD undertook an extensive analysis consisting of two parts: 1) a quantitative analysis using product-level time series sales data to explore whether therapeutic competition occurs, and, if so, how it has affected prices and volumes over time, based on a sample of countries and therapeutic classes and 2) a review of current practices and policies on pricing, coverage and procurement of on-patent medicines to identify whether these have been influencing competition between alternative therapeutic products. This report presents the key findings from this analytical work.

The health system performance assessment (HSPA) framework for the Czech Republic is an initiative designed to help the Czech health system improve policy planning, monitoring, and decision taking. This report describes the HSPA framework for the Czech Republic, its development process, governance structure and implementation roadmap. It also details the Czech HSPA framework domains, populated by indicators selected through a comprehensive review process. As such, the framework enables the assessment of strengths and weaknesses of the Czech health system. Its implementation will increase the accountability of national authorities and principal healthcare stakeholders, improve public involvement, smooth flow of information across the health sector, and allow reform planning and monitoring.

People today are living longer with complex health needs but often receive fragmented care. This has prompted countries to support patient-centred, integrated care models. As part of OECD’s work on best practices in public health, this report outlines policy recommendations to prevent and manage chronic diseases by integrating care. Policy recommendations were drawn from a review of key integrated care models implemented in OECD and EU27 countries.