Different health systems adopt various strategies for funding innovation in healthcare. Some countries, like the United States, rely heavily on private investment and venture capital to drive medical advancements. In contrast, countries with publicly funded health systems, such as the United Kingdom, often allocate government resources and grants to support research and development. Additionally, public-private partnerships play a crucial role in fostering innovation across many regions, combining the strengths of both sectors. These diverse approaches reflect the unique economic, political, and social contexts of each health system, influencing how new technologies and treatments are developed and implemented. In general three types of innovation can be identified:
Biomedical innovation aims to enhance our understanding of and ability to intervene in the biological systems of the body. This type of research is grounded in the life sciences. For instance, biomedical innovation might lead to the development of an anti-cancer drug that works by disrupting the mechanisms that drive cell growth and proliferation, potentially benefiting anyone with the relevant biological profile.
Technological innovation focuses on leveraging technology to improve health outcomes. Its research is rooted in the physical and information sciences. This category includes a wide range of advancements, from medical devices like artificial hips and monitoring equipment to telemedicine platforms and machine learning algorithms that can analyse retinal scans to identify eye diseases.
Organizational innovation centres on improving the functioning of healthcare organisations and systems. This research is based in the social sciences and its findings are context-specific, varying with each health system and organization. For example, the organization of care for a particular condition depends on factors such as the skills of the health professionals involved, organisational structures, local geography like distances and population density, and the payment mechanisms of the health system.
Workshops for the Ministry of Health
and National Health Insurance of France
and National Health Insurance of France
Discovering novel care and payment methods that enhance patient care while ensuring healthcare sustainability is an ongoing endeavour aimed at maintaining high-quality and affordable healthcare services for the public. One approach to nurturing such innovation is through dedicated funding programs. These national funding programs that invest and provide support to the development of new care and payment models are relatively young. While the search for care and payment models are context-dependent on the goals and organization of individual health systems, lessons on how to manage, prioritise and allocate resources may be universal.
For this purpose, the European Observatory on Health Systems and Policies in collaboration with the Ministry of Solidarity and Health of France and the national agency of the Statutory Health Insurance of France (CNAM) organised a series of workshops to exchange experiences and extract potential lessons. The national funding programmes of Germany, France, the United Kingdom, and the United States participated in the workshops and exchanged their experiences on the following questions:
1. What are the priorities and how do we engage stakeholders?
2. What does it take to make the fund work?
3. How do we know it works?
2. What does it take to make the fund work?
3. How do we know it works?
Presentation at the European Public Health Conference of 2021
A workshop session was organised for the European Public Health Conference in 2021 to facilitate further cross-country learning and share the lessons of dedicated funding programmes for new care and payment models with the wider public.
The innovation and implementation of care and payment models come with different challenges in comparison to biomedical and technological innovation. These Models are inherently social, context-sensitive, and dynamic, therefore posing challenges for replication. Even so, there are opportunities to glean insights from diverse experiences across different countries to understand fundamental factors for the success and failure of models.
Article "Why Organisation Innovation matters"
Innovation is a pivotal challenge for health systems. Despite significant investments in biomedical innovation, continuously pushing the boundaries of medical possibilities, these advancements sometimes fail to address areas of greatest need. While certain health domains, like cancer care, witness ongoing medical breakthroughs, others, such as mental health, stay behind. The crucial step of adoption, which translates health innovations into practical applications, often receives insufficient attention. While substantial investments are made in technical and biomedical innovation, there is a notable lack of investment in understanding the innovation needed in health service delivery to translate these promised results into improved patient care. Consequently, there exists a substantial and persistent implementation gap. This inefficiency in resource allocation results in suboptimal utilisation of health system resources and falls short of achieving the health outcomes already within reach.
Rapid Review of literature on the effects of alternative payment methods on Healthcare Coordination and Integration
To keep health care sustainable, there is a need to find suitable ways of organising and structuring health care that are better applicable to the treatment of non-communicable diseases and multimorbidity. Improving coordination processes across different health and social care actors is crucial to make this happen, however current payment systems can be an obstacle to achieving this.
Some theoretical models suggest that bundled payments might be an appropriate payment mechanism for improving cooperation between organisations and quality of care overall. Population-based payments are also believed to be promising but do require advanced data and information technology systems to function properly. Then there are additional payments or add-on payments to attain additional goals that providers are otherwise less incentivised to do.