Performance Based Contracting for Hospitals in Lebanon

Abstract

Around 87% of the Ministry of Public Health (MOPH) budget is allocated for curative care, of which 79% is used to reimburse contracted hospitals. Such figures highlight the necessity to enhance the efficiency of MOPH spending. There has been significant investment in quality of healthcare in Lebanon, while limited information is available about health outcomes. Thus, reforming payment mechanisms is needed to ensure cost containment while improving quality of care and patient safety. Successful implementation of a P4P scheme aiming at improving outcomes of care at hospitals in Lebanon requires the following recommendations:→ Development of a hybrid contractual arrangement between MOPH and hospitals whereby the hospital reimbursement formula includes: 1) A proportion based on improved accreditation standards; 2) A proportion based on additional indicators retrieved from the hospitalization database of MOPH, including the Case Mix Index, readmission rate and patient satisfaction.→ Involvement of major stakeholders and communication of the program thoroughly and directly throughout its development, implementation, and evaluation phases.→ Provision of trainings for healthcare personnel at hospitals to lead and implement quality improvement initiatives since building their capacity is critical for successful implementation of P4P.