Payers for health care are pursuing a variety of policies as part of broader efforts to improve the quality and efficiency of care. Payment reform is but one policy tool to improve health system performance that requires supportive measures in place such as policies with well-developed stakeholder involvement, information on quality, clear criteria for tariff setting, and embedding evaluation as part of the policy process. Countries should not, however, underestimate the significant data challenges when looking at price setting processes. Data access and ways to overcome its fragmentation require well-developed infrastructures. Policy efforts highlight a trend towards aligning payer and provider incentives by using evidence-based clinical guidelines and outcomes to inform price setting. There are signs of increasing policy focus on outcomes to inform price setting. These efforts could bring about system-wide effects of using evidence along with a patient-centred focus to improve health care delivery and performance in the long-run.
The OECD Health Working Papers series is designed to make available to a wider readership health studies prepared for use within the OECD.
How health providers are paid is one of the key policy levers that countries have to drive health system performance. The 2012 HSC Survey analyses the payment modes currently in use in OECD countries to remunerate primary care, outpatient specialist care and inpatient care, the price regulations for health services and identifies new innovative modes of payments in more detail.
Despite remarkable progress in health status and life expectancy in OECD countries over the past decades, there remain large inequalities not only across countries, but also across population groups within each country. These inequalities in health status are linked to many factors, including differences in exposure to risk factors to health and in access to health care.
The OECD carries out work on health data and indicators to improve international comparisons and economic analyses of health systems.
The OECD Health Division is releasing a new series to highlight its work on health policies and data. A new graph will be available each month.
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In the past 30 years Korea has gone from having a limited medical infrastructure, fragmented financing and limited population coverage, to a health care system characterised by universal coverage, one of the highest life expectancies in the world while still having one of the lowest levels of health expenditure among OECD countries.
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Israel has built a universal health system at relatively low-cost. Health spending was 7.5% of GDP in 2013, below the OECD average of 8.9% although the health spending share of GDP has been increasing rapidly, particularly in recent years. Israel has developed a sophisticated programme to monitor quality of primary care.
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Norway has an impressive and comprehensive health system, but it is facing several challenges over the coming years. The shift in the need for care from an ageing population will weigh heavily on the Norwegian health care system, demanding for more skilled health care personnel as well as strengthening of community care.
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Between 2009 and 2013, public spending on health fell by EUR 5.2 billion – representing a 32% drop in real-terms. This reduction clearly represents a shock for the system to adsorb, even though it is clear that there were inefficiencies in the Greek system (for example, inappropriate prescribing, weak primary care, imbalances in the mix of health professionals).