Innovative Pricing for the Benefit of Patients
This project aims to develop and evaluate healthcare reimbursement models that encourage providers to deliver care that yields the best outcomes for patients and foster continuous improvement among healthcare teams. The models will be developed for two types of procedures: hip replacement and the treatment of localized, non-metastatic prostate cancer (prostatectomy and radiation therapy). To measure the quality of these procedures, the project partners will rely, among other things, on data from patient-reported health outcome questionnaires. This approach involves directly asking patients how they feel about their health and quality of life before and after treatment. The efficiency of the care provided will also be evaluated based on the cost-benefit ratio. Whenever possible, data will be analyzed throughout the entire patient care pathway, as treatment outcomes depend on multiple providers and their coordination.
Rewarding Quality, Not Quantity
The project was designed based on the value-based healthcare approach. Value-based healthcare aims to provide patients with high-quality and efficient care. A payment system that rewards quality—as judged by medical outcomes—rather than quantity helps to promote this approach, which is based on the systematic measurement of care outcomes and their impact on patients’ quality of life. This goal of maximizing quality and efficiency in the delivery of care perfectly reflects the rationale behind the criteria of effectiveness, appropriateness, and cost-effectiveness, which are the pillars of our healthcare system.
“With this pilot project, we want to demonstrate that value-based pricing is one of the levers for encouraging optimal patient outcomes at the heart of our healthcare system,” summarizes Daniel Volken, deputy director at Groupe Mutuel. This approach is now widely supported by numerous organizations, including hospitals, insurers, and the pharmaceutical industry. Hôpital de la Tour and the University Hospital of Basel are already collaborating in this area with Johnson & Johnson and Roche, respectively.
A First-of-Its-Kind Partnership with Hospitals Pioneering the Measurement of Health Outcomes
The development of innovative pricing models—which place quality and the patient at the center—required the creation of a first-of-its-kind partnership between an insurer, Groupe Mutuel, and healthcare providers, the University Hospital of Basel and Hôpital de La Tour. The project partners will thus be able to draw on their respective expertise to assess the potential of incentive-based pricing. “We are convinced that this project will help embed the value-based healthcare approach into daily practice,” says Dr. Florian Rüter of the University Hospital of Basel. The hospital is a pioneer in measuring patient-reported health outcomes in Switzerland. Since 2017, the University Hospital has been systematically collecting outcomes reported by female breast cancer patients as well as for 13 other conditions. Hôpital de La Tour measures patient-reported outcomes in orthopedics and oncology. In both Basel and Meyrin, the data collected enables doctors to improve the quality of care and communicate more effectively with their patients.
“This collaboration supports our strategy of holding the hospital accountable for medical outcomes for the benefit of patients, ensuring excellence in care, and fostering continuous improvement. VBHC serves the long-term interests of both patients seeking the best possible care and our healthcare system striving for efficiency.”, concludes Rodolphe Eurin, Director of Hôpital de La Tour. Thanks to the support of the Groupe Mutuel Foundation, the project is also supported by the “Health Economics” Chair at the University of Basel.