Alternative Reimbursement Models for Health Providers in High-Performance Sport : Stakeholder Experiences and Perceptions

© 2023. The Author(s)..

BACKGROUND: Value-based healthcare provider reimbursement models have been proposed as an alternative to traditional fee-for-service arrangements that can align financial reimbursement more closely to the outcomes of value to patients and society. This study aimed to investigate stakeholder perceptions and experiences of different reimbursement systems for healthcare providers in high-performance sport, with a focus on fee-for-service versus salaried provider models.

METHODS: Three in-depth semi-structured focus group discussions and one individual interview were conducted with key stakeholders across the Australian high-performance sport system. Participants included healthcare providers, health managers, sports managers and executive personnel. An interview guide was developed using the Exploration, Preparation, Implementation, Sustainment framework, with key themes deductively mapped to the innovation, inner context and outer context domains. A total of 16 stakeholders participated in a focus group discussion or interview.

RESULTS: Participants identified several key advantages of salaried provider models over fee-for-service arrangements, including: the potential for more proactive and preventive models of care; enhanced inter-disciplinary collaboration; and the ability for providers to have a deeper understanding of context and how their role aligns with a broader set of priorities for an athlete and the organisation. Noted challenges of salaried provider models included the potential for providers to revert to reactive care delivery when not afforded adequate capacity to provide services, and difficulties for providers in demonstrating and quantifying the value of their work.

CONCLUSIONS: Our findings suggest that high-performance sporting organisations seeking to improve primary prevention and multidisciplinary care should consider salaried provider arrangements. Further research to confirm these findings using prospective, experimental study designs remains a priority.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:9

Enthalten in:

Sports medicine - open - 9(2023), 1 vom: 11. Juli, Seite 53

Sprache:

Englisch

Beteiligte Personen:

Carter, Hannah E [VerfasserIn]
Allen, Michelle J [VerfasserIn]
Toohey, Liam A [VerfasserIn]
McPhail, Steven M [VerfasserIn]
Drew, Michael K [VerfasserIn]

Links:

Volltext

Themen:

Economic
Embedded provider
Fee-for-service
Financial
Health care
Incentives
Journal Article
Outcomes
Pay-for-performance
Salary

Anmerkungen:

Date Revised 18.07.2023

published: Electronic

Citation Status PubMed-not-MEDLINE

doi:

10.1186/s40798-023-00600-9

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM359336248