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R. Jung, P. Einzinger, N. Pfeffer, N. Popper:
"A Decision-Support Tool for Choosing Between Alternative Payment Models for Multispecialty Group Practices";
Poster: 15th Biennial European Meeting of the Society for Medical Decision Making, Antwerpen, Belgien; 08.06.2014 - 10.06.2014; in: "15th Biennial European Meeting of the Society for Medical Decision Making: ESMDM Meeting Abstracts", Medical Decision Making, 34 (2014), ISSN: 0272-989x; S. E44.

Purpose: In Austria, the existing payment mechanism for ambulatory health care has a strong fee-for-service component. Due to legal requirements, however, Austrian sickness funds have to implement a new payment system with a focus on lump sum payment for multispeciality group practices. As a consequence, 3 different payment models have been developed. Policy makers from different sickness funds are now faced with choosing among them. Moreover, for each single contract between a sickness fund and a multispeciality group practice, the specific context has to be considered. To facilitate the choice among the 3 payment models, there is a need for a decision support tool that can be used by analysts and decision makers of different sickness funds who are not familiar with simulation software.
Methods: We used a system dynamics approach modeling the financial consequences of the implementation of different payment systems. Next, we selected a set of parameters representing the most important assumptions that have to be varied to appropriately adapt the model for the specific needs for a decision (e.g., referral behavior and working hours). After specifying a value range for those parameters, we conducted 1.4 million simulations for every possible combination of parameter values. Finally, we developed an easy-to-use interface for accessing and displaying the stored results.
Results: A decision support tool running on a standard spreadsheet program. Scenarios can be quickly varied by choosing different parameter values via a drop-down menu. Results are displayed instantly as an appealing table or graph.
Conclusions: Our approach allows analysts and decision makers from Austrian sickness funds to test different model assumptions quickly and independently (without the need for simulation software skills). Consequently, it raises acceptance for the simulation model and increases the chances that simulation results actually support decisions among alternative payment models.

Group Practices, Decision-Support, System Dynamics, Payment System

http://dx.doi.org/10.1177/0272989X14547195