ReviewBMC health services research2018
Effects of mixed provider payment systems and aligned cost sharing practices on expenditure growth management, efficiency, and equity: a structured review of the literature.
Review in BMC health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
38 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Strategies for controlling communicable diseases in Afghanistan: a realist review.BMC public health · 2025Pooled it
- Health Insurance Schemes and Their Influences on Healthcare Variation in Asian Countries: A Realist Review and Theory's Testing in Thailand.International journal of health policy and management · 2024Pooled it
- Challenges of Wearable Biosensors and Ways to Overcome Them.Biosensors · 2026Review
- Paying for hospital care in seven central and Eastern European countries - a comparative analysis.Health economics review · 2026Article
- Blended Payment Models and Care Transitions: Analysis of a Statewide Payment Reform's Impact on Transitions in Care and Care Termination From Outpatient Substance Use Treatment.Substance use & misuse · 2026Article
- Impact of Diagnosis-Intervention Packet (DIP) Payment Reform on County Hospitals: Evidence from Z City, China.Journal of healthcare leadership · 2026Article
- Incentivizing co-occurring disorder diagnoses through blended payments.Social science & medicine (1982) · 2026Article
- The impact of Croatia's 2013 Primary Care Payment Reform: an exploratory case study of a rural family practitioner group practice.Croatian medical journal · 2025Article
- Integrating nursing activities into general practices in Switzerland: a mixed-methods study.Primary health care research & development · 2025Observational
- Health care provider payment schemes and their changes since 2010 across nine Central and Eastern European countries - a comparative analysis.Health policy (Amsterdam, Netherlands) · 2025Article
- Reducing fragmentation of primary healthcare financing for more equitable, people-centred primary healthcare.BMJ global health · 2025Article
- How cesarean section rates can be reduced through an effective financial strategy: A protocol for systematic review.Medicine · 2025Article
- Effects of Hospital Payment Reform of Government Budget Allocation and Social Health Insurance in a Pilot in China.International journal of health policy and management · 2025Article
- Health care provider payment reforms in African states of the Commonwealth-a scoping review.Frontiers in public health · 2025Article
- Barriers of access to primary healthcare services by National Health Insurance Fund capitated members in Uasin Gishu county, Kenya.BMC health services research · 2024Article
- Impact of health benefit package policy interventions on service utilisation under government-funded health insurance in Punjab, India: analysis ofThe Lancet regional health. Southeast Asia · 2024Article
- Impact of reimbursement systems on patient care - a systematic review of systematic reviews.Health economics review · 2024Review
- A cost-reducing reimbursement programme? Effects of value-based reimbursement on healthcare costs.Frontiers in public health · 2024Observational
- Framework for responsive financing of district hospitals of India.Frontiers in public health · 2024Article
- Exploring the association between primary care efficiency and health system characteristics across European countries: a two-stage data envelopment analysis.BMC health services research · 2023Article
Corrections and comments
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Authors and funding
2 authors.
Funding
Abstract
backgroundStrategic purchasing of health care services has become a key policy measure on the path to achieving universal health coverage. National provider payment systems for health services are typically characterized by mixes of provider payment methods with each method associated with distinct incentives for provider behaviours. Reaching incentive alignment across methods is critical to enhancing the effectiveness of strategic purchasing.
methodsA structured literature review was conducted to synthesize the evidence on how purposively aligned mixed provider payment systems affect health expenditure growth management, efficiency, and equity in access to services with a particular focus on coordinated and/or integrated care management.
resultsThe majority of the 37 reviewed articles focused on high-income countries with 74% from the US. Four categories of payment mixes were examined in this review: blended payment, bundled payment, cost-containment reward models, and aligned cost sharing mechanisms. Blended payment models generally reported moderate to no substantive reductions in expenditure growth, but increases in health system efficiency. Bundled payment schemes consistently report increases in efficiency and corresponding cost savings. Cost-containment rewards generated cost savings that can contribute to effective management of health expenditure growth. Evidence on aligned cost-sharing is scarce.
conclusionThere is lacking evidence on when and how mixed provider payment systems and cost sharing practices align towards achieving goals. A guiding framework for how to study and evaluate mixed provider payment systems across contexts is warranted. Future research should consider a conceptual framework explicitly acknowledging the complex nature of mixed provider payment systems.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.