The Use of Risk-Sharing Contracts in Healthcare: Theoretical and Empirical Assessments

Volume 37, Issue 12, December 2019


Systematic Review
The Use of Risk-Sharing Contracts in Healthcare: Theoretical and Empirical Assessments
Over 20 studies proposed different taxonomies of risk-sharing contracts, which can be summarised as financial and paying-for-performance agreements. Theoretical studies modelling the incentives to implement risk-sharing agreements are scarce; they addressed different types of contracts and regulatory contexts, characterizing the drug prices and the optimal strategies of the involved agents. Empirical studies describing specific agreements are abundant and referred to different geographical contexts; however, few articles showed the economic results and assessed the value of such contracts. Stakeholders’ perceptions of risk-sharing contracting were favourable, but little is known about the economic and clinical advantages of specific agreements. Whether risk-sharing contracts have yielded the desired results for healthcare systems remains uncertain.. Risk-sharing contracts are increasingly used, although the lack of transparency and aggregated registries makes it difficult to learn from these experiences and assess their impact on healthcare systems.
Fernando Antonanzas, Carmelo Juárez-Castelló, Reyes Lorente