EXPERTS' VIEWS ON THE INTRODUCTION OF A MONOPSONY IN HEALTH CARE SERVICES IN GREECE

Author(s)

Skroumpelos A, Zavras D, Pavi E, Kyriopoulos JNational School of Public Health, Athens, Greece

OBJECTIVES: In light of the financial crisis, the largest social insurance funds were merged. This study aims to investigate the possibilities of a monopsony and to propose alternative methods for the new fund to allocate resources and to reimburse physicians.  METHODS: A structured questionnaire concerned with the potentials of the new initiative, the resource allocation method and the physicians’ reimbursement methods was constructed. An interdisciplinary expert panel was assembled and asked to provide its opinion on the above issues. RESULTS: A total of 66.7% of the experts supported the monopsonistic character of the fund unlike 33.3% who preferred a bilateral monopoly structure. However, expert’s opinion on the potential of the fund to control expenditure and reduce cost of time and prices was not clear, while the majority argued that the fund can hardly guarantee adequate quality services. 68.2% agreed on the introduction of regional global budgets and the majority argued that the parameters to calculate the budget should be the region’s population, the female, the birth, the elderly and the chronic condition patient rates and the standard mortality ratio. The introduction of an internal market and capitation reimbursement for general practitioners and pediatricians were widely accepted. Incentive payments for both the above specialties were approved and determined according to the home visits for the pediatricians and according to the number of the enrolled elderly and chronic condition patients, the carry out of screening and the home visits for the general practitioners. Per-item reimbursement for specialists was weakly supported. The introduction of an internal market along with global budgets and incentive payments was argued that could control expenditure and supplier-induced demand, and improve equity in access and outcomes.  CONCLUSIONS: Experts argue that a public monopsony in Greece can hardly guarantee efficiency and effectiveness, unless included in a wider reform framework of prospective payments, market-like mechanisms and financial incentives.

Conference/Value in Health Info

2012-11, ISPOR Europe 2012, Berlin, Germany

Value in Health, Vol. 15, No. 7 (November 2012)

Code

PHP107

Topic

Health Service Delivery & Process of Care

Topic Subcategory

Hospital and Clinical Practices

Disease

Multiple Diseases

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