Presentation (CTI)

OBJECTIVES: Cardiovascular disease is a major contributor to morbidity, mortality, and health care spending worldwide. Traditional fee-for-service payment may insufficiently encourage coordination, prevention, and efficient resource use in cardiology. Alternative payment models (APMs) aim to realign financial incentives toward value. However, a comprehensive overview of how APMs in cardiological care are designed and their effects remains limited.
This scoping review provides an overview of APMs implemented in cardiological care. It describes key design elements — including type of payment model, accountable entities, participating providers, scope of services, and applied risk-mitigation strategies — and inventories empirical evidence on effects related to clinical outcomes, health care utilization, and cardiovascular spending.
METHODS: A scoping review protocol was developed in accordance with the PRISMA-ScR guidelines. In collaboration with an information specialist, search strategies were iteratively developed for PubMed, Embase, Web of Science, CINAHL, and the Cochrane Library (January 2007-present). Strategies combined controlled vocabulary and text-word terms for cardiology, APMs (e.g., bundled payments, shared savings, global budgets, pay-for-performance), and evaluation concepts. Eligible records describe or evaluate APMs in cardiology in high-income settings. Peer-reviewed studies and relevant gray literature are included; non-empirical commentaries are excluded. Data are charted using a predefined framework, informed by prior work on APMs, capturing design features, accountable entities, population and episode scope, services covered, quality linkages, risk-mitigation strategies, and reported outcomes. Descriptive synthesis will map models and evidence gaps.
RESULTS: Searches are completed and screening is ongoing. Early records indicate considerable variation in how APMs are designed and implemented across cardiological care. Where reported, effects span outcomes, utilization, and spending, but are inconsistently measured. Final data extraction and synthesis will be completed before the conference.
CONCLUSIONS: This review will map how APMs in cardiological care are designed and summarize what is currently known about their effects, supporting discussions on value-oriented payment reforms in cardiology.