On September 10, 2024, Prof. Qian Long (Associate Professor of Global Health, Duke Kunshan University) shared findings from a case study of China at the World Health Organization (WHO) webinar titled “Blending Capitation with Performance-Based Payment: Does it Improve the Quality of Chronic Care?”
Prof. Long and her team participated in a multi-country collaborative research effort in 2022 and published the case study on China’s National Basic Public Health Services Program (NBPHSP) in October 2023. China launched the NBPHSP in 2009 to achieve universal coverage of basic public health services. Under the program, basic public health services are fully purchased by the government through performance-based capitation payments.
Despite that the program has improved the coverage of health management for chronic conditions such as hypertension, type 2 diabetes, severe mental disorders and tuberculosis, the performance-based payments only constitute a small proportion of the capitation payments, failing to incentivize high-quality service provision. Because of overall funding constraints for facility operations and the limited local capacity to implement a true performance-based salary system, primary care providers’ salaries are often based on the volume of services provided rather than the quality of care delivered. Inadequate compensation and a lack of career development opportunities further exacerbate the shortage of qualified healthcare workers and make it difficult to retain them at the primary care level.
In her presentation, Prof. Long highlighted, “Performance assessment should take into account variations in local capacities and increase investment in primary care facilities and human resources to address inequalities, especially in under-resourced areas.” Overcoming these systemic barriers is crucial to enhancing incentives, improving service quality, and ensuring better health outcomes for all in both the short and long term.
The webinar was organized by the WHO Centre for Health Development (WHO Kobe Centre – WKC) and the WHO Health Financing and Economics (HFE) Unit. Based on collaborative research by the WHO Kobe Centre – WKC and the WHO HFE Unit in conjunction with the Organization for Economic Cooperation and Development (OECD), the event explored and shared experiences and initiatives of blending capitation with performance-based payment from various countries.
More about the webinar: https://wkc.who.int/resources/news/item/22-08-2024-webinar-blending-capitation-with-performance-based-payment-does-it-improve-the-quality-of-chronic-care
by Chu Ren
