Challenges of, Performance-based Payment (ghasedak) Program in Iranian hospitals

Abstract

Abstract Introduction: Performance-based payment has been the focus of many organizations so that they can clearly define their organizational goals and determine the criteria for achieving organizational goals; and based on those criteria, determine the performance in achieving goals and be fair in proportion to performance Objective: The aim of this study was to investigate the challenges of performance-based payment model (Ghasedak plan) in Iranian hospitals. Methods: To achieve the objectives of this qualitative study, the first step was to systematically review performance-based payment features and challenges in the health system of the world, and in the second step, using Interviewing and Focused Group Discussion (FGD) method, Performance-based payment challenges (Ghasedak plan) were extracted from expert perspectives (physicians, nurses, administrative-financial staff, and executives directors). After completing the FGD and individual interviews to identify the features and challenges, two roundtable discussions and review of documentation were conducted by the research team. In the next step, the results of the first and second steps of the Executive Proposal were formulated to modify the implemented model and finalized in the expert’s panel.

Results: Based on the findings of the study, performance-based payment challenges were categorized according to control knobs, which included financing challenges, organizational challenges, rules and regulations challenges, Behavior Management Challenges and Payment Challenges. And modify suggestions were made for successful implementation of performance-based payment (Ghasedak plan) based on control knobs. Conclusion: Given that different countries have adopted different approaches to performance-based payment plans in the health system. According to the results of this study, increasing awareness and changing the attitude of health system policy makers and managers about this plan and creating the required infrastructure can be effective in establishing and implementing a successful performance based payment plan.