Background: Governments and insurance organizations reimburse healthcare providers for delivering health goods and services. Payment methods to healthcare providers significantly impact the quality, cost, and accessibility of healthcare services. Nevertheless, the provider payment system faces several challenges. This study aimed to identify and elucidate the payment methods used for healthcare providers.
Methods: This study was conducted as a narrative review in 2024. English and Persian databases such as PubMed, Web of Science, Scopus, Magiran, and SID, as well as search engines like Google Scholar and Google, were utilized to obtain scientific evidence. The keywords used for this search included payment methods, providers, and healthcare system in both Persian and English.
Results: In this study, 11 payment methods for healthcare providers were identified (i.e., per admission, per Diem, Budget, Salary, Capitation, Fee for service, Case-based, Pay for performance, Bonus, Bundled, and Blended). The advantages and challenges of each of these methods were discussed. A combination of these methods can mitigate the disadvantages of each and enhance the overall benefits of the payment method for healthcare providers. Prospective fixed payment methods, along with variable performance-based methods, are deemed appropriate and contribute to improved access, quality, and efficiency.
Conclusion: The selection of an appropriate payment method for healthcare providers depends on factors such as the characteristics and objectives of the healthcare system, as well as the political, economic, and social conditions of the country. There is no one-size-fits-all solution, and a combination of methods may yield the best outcomes. |
