Addressing historical problems of incentives for cost and outcome shifting, cream skimming (cherry picking less complex patients) and cost minimising care requires jointly addressing accountability for quality and cost of care in monitoring efficiency of the health system across time. Ideally, such accountability would also align with the net benefit maximising objective underlying processes of health technology assessment for evidence based medicine and government objectives more widely.
Internationally recognised health economic methods for best informing comparison of the cost effectiveness of multiple strategies in health technology assessment developed by Professor Simon Eckermann (UOW) in collaboration with Professor Andrew Willan from Canada and Professor Briggs from the UK have been extended in a collaboration between Professor Eckermann and Professor Tim Coelli (UQ) to allow inclusion of quality consistent with maximising net benefit in efficiency measures in practice.
The article ‘Including quality attributes in efficiency measures consistent with net benefit: Creating incentives for evidence based medicine in practice’’ http://dx.doi.org/10.1016/j.socscimed.2012.10.020 published in Social Science and Medicine provides a robust method, the net benefit correspondence theorem, which for the first time allows economic efficiency measures consistent with maximising net benefit but also support for data linkage and risk factor adjustment in preventing cost shifting and cream skimming incentives. This directly supports current health care reform and the objectives and missions of bodies such as the NHPA and IHPA to “improve quality, increasing transparency and drive value for money in the health care system”, while preventing historical problems of cost shifting and cream skimming incentives with efficiency and performance monitoring of activity based funding.
These methods will be taught from first principles and their policy implications addressed by Professors Eckermann, Willan (www.andywillan.com) and Coelli as part of the short course:
Health Economics from Theory to Practice: optimally informing related decisions of research, reimbursement and regulation in practice which will be run by UOW in Adelaide from April 3-5 2013.
For further information contact Megan Edgar on (02) 4221 8138 or Professor Simon Eckermann on (02) 4221 4030.