Towards tariffs differentiation in supplementary healthcare: A multi-parametric method rooted in technological excellence and organisational maturity

Background: Current reimbursement models in healthcare overlook variations in medical procedure quality and are characterised by flat rates. This approach offers limited incentives for care providers to invest in more advanced medical technology and/or organisational practices. Methods: This study develops and applies a novel multi-parametric method to support the differentiation of reimbursement rates by classifying the delivery of medical procedures into three quality groups—excellent, advanced, and essential—based on two dimensions: technological excellence and organisational maturity. Results: The method was applied to five pilot medical procedures: CT angiography, prostatectomy, pacemaker implantation, total knee arthroplasty, and radiotherapy. Results confirm, on the one hand, the model’s capability to differentiate the quality of medical procedures and, on the other hand, care providers’ capability to collect all the required data. Conclusions: By integrating this method into current reimbursement systems, supplemental care funds could encourage care providers to continuously improve medical procedures by adopting more advanced technology or organisational practices, thus contributing to enhanced patient outcomes, in line with the principles of Value-Based Health Care.