Healthcare Payment-for-Performance in the Czech Republic from Behavioral Economics and Nudge Theory Perspectives
Abstract
The objective of this paper is to analyze positive and negative outcomes of financial incentives within Payment for Performance (P4P) in health care in the Czech Republic from both international and cross-sectorial comparative perspective. P4P policymaking processes will be reviewed employing behavioral economics and nudge theory instruments as well as public policy theories focused on stakeholders and historical institutionalism.
On one hand there is a public and political consensus for supporting healthy lifestyle but on the other there are barriers stemming from the belief in why doctors should be rewarded for something that is their job and duty. The paper aims to fill in this gap.
P4P as a method of reimbursement in healthcare may encourage other healthcare providers to raise healthcare quality, quality of life of patients and bring savings, for instance in obesity. Given that diabetes belongs to the so-called diseases of civilization and its development can be positively influenced by a suitable lifestyle and the improvement of living conditions, it seems possible not only to reduce the number of new patients but also achieve the remission of the disease and relieve public budgets.
P4P with the use of behavioral economics interventions seems to be one of the possible policy options to mitigate the problem as it is based on fair and ethical care for patients, supporting the patient-doctor relations, voluntary participation, using accurate and relevant data and providing fair bonuses for positive outcomes. Hence, the aim of the discussion will be to apply a theoretical lens of behavioral economics and the nudge theory in the analyses of P4P.
The paper was based on desk research which included processing secondary data, performing comparative analysis (with the practice in the UK, the USA and Germany) and the analysis of related documents. Results show that Payment for Performance programs are associated with high administration and commission costs.
On the other hand, the programs enhanced the patient's health and satisfaction with care in the western countries (Germany, the US, the UK) and may serve as an inspiration for a similar investigation especially in the countries of Central and Eastern Europe.