funding mechanisms

Formal reimbursement mechanisms

In the EU, healthcare funding is dealt with under the principle of subsidiarity which means that decision-making is handled at a national (or in some cases regional) level. There are currently no plans to mirror the regulatory situation and move to a single European system for reimbursement. This means that reimbursement has to be considered country-by-country and, in some countries (such as Spain and Italy), at a sub-national level.

Translucency advises on the formal reimbursement mechanisms for a product or service in each market of interest. This will include Diagnosis Related Groups (DRG) or (in the UK) Healthcare Resource Groups (HRG) systems that are increasingly the basis of funding hospital care, the various fee-for-service systems, and formal applications such as the Drug Tariff for medical devices or NICE appraisals in the UK, OPS Procedure Codes in Germany, EBM and GÖA reimbursement codes in Germany and LPPR listing for implants in France.