The essence of a prospective payment system (PPS) is that the amount of insurance compensation is based on a predetermined payment, regardless of the intensity of the rendered service. This payment system aims to provide high-quality services without severe risks to current resources for both clients and medical organizations. Payers have a choice in determining how they pay to ensure that risks are shared fairly. Thus, a situation arises in which the payment system benefits extend to both payers and healthcare service providers. This payment system, which replaced the retrospective payment system, can positively affect the quality of transplant services.
Transplantation is a procedure that is done to replace organs with healthy donor organs. The surgery is only one part of a complex, long-term process. The current coronavirus situation seriously hampers the provision of medical care for transplantation (de Vries et al., 2020). The transportation of organs was limited due to the high probability of transmission of the virus. Such limitations negatively affected the health of citizens in need of a transplant operation. Recently, the problems of obsolescence of the retrospective payment system compared to the prospective one have also become especially urgent. The decline in hospital attendance due to COVID-19 leads to a decrease in the revenue of healthcare companies. PPS can solve this problem by introducing a prepayment system to keep the income at a stable level. The amount of the prepayment is made up of the results of the patient’s diagnosis and covers a particular time, such as, for example, the period of the patient’s stay in the clinic.
The introduction of this payment system motivates employees of a medical organization to work together to increase their total income. Such a policy in the provision of organ transplant services can improve the quality of services provided. Patients requiring a transplant are among the clients who most need to be diagnosed as quickly as possible. It is precisely this quickness of diagnosis that the introduction of the analyzed payment system can provide. In addition, prospective payment systems are proving to be effective in reducing costs in an organization’s operations, which is also crucial in terms of the financial performance of a health services provider.
The introduction of PPS can help when employees who want to receive additional rewards are engaged in treatment that is unnecessary for the client. The established amount of payment for the services provided will also reassure clients for whom it is essential not to spend too much money. Moreover, organ transplant services are among the most expensive in the healthcare sector. The relevance of reducing the cost of services for patients who decide to undergo a transplant is confirmed by the availability of studies on this topic (Barreto et al., 2019; Webb et al., 2021). Since it is important to consider not only the needs of the organization itself but also of the customers, it is necessary to search for optimal solutions, which can be the introduction of PPS.
In addition to the usual standard fees for transplant services provided, many healthcare organizations add the cost of additional fees. The total amount spent on the surgery can be unpredictable. Therefore, to solve financial and organizational problems arising at different stages, it is proposed to implement PPS. This system has already been able to prove its effectiveness for the activities of healthcare organizations. It has been conducted that PPS positively affects the quality of transplant services.
Barreto, M., Dellaroza, M., Fernandes, K., Pissinati, P., Galdino, M., & Haddad, M. (2019). Hospitalization costs and their determining factors among patients undergoing kidney transplantation: a cross-sectional descriptive study. Sao Paulo medical journal = Revista paulista de medicina, 137(6), 498–504. Web.
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