The highly regarded Austrian health system delivers good quality and easily accessible services, but is costly. Its
governance and funding structure is highly fragmented and it makes too much use of inpatient care in hospitals. Entry
and competition opportunities are de facto limited in most health markets. The system operates therefore on a
supply-driven basis, and does not have clear mechanisms to optimize spending on a cost-benefit basis. Population
lifestyles are also not supportive of good health outcomes and suffer important differences between social groups,
raising risks for the future. This Working Paper reviews Austrian authorities’ responses to these challenges, and
makes recommendations based on OECD countries’ experiences. The suggested priorities are: i) more clearly
assigning the performance, financing and spending responsibilities in the system, ii) enforcing a national capacity
plan for publicly-funded inpatient and outpatient care, iii) introducing performance-based payment mechanisms in all
services, iv) promoting the transition to “integrated care” by better balancing preventive, outpatient, inpatient,
rehabilitation and long-term care, v) emphasizing healthier lifestyles and monitoring progress against national health
goals (such as targets for obesity and overweight rates), and vi) better clarifying the medium-term fiscal outlook and
scenarios of the system.
This working paper is a slightly revised and completed version
