Analysis of 3 Financial Models in the Health System: Pay-for-Performance, Results-Based-Budgeting, Capitation
Miguel Angel Serna Martínez
Maestría en Salud Pública, Área Académica de Medicina, Instituto de Ciencias de la Salud, Universidad Autónoma del Estado de Hidalgo, México.
Beatriz Garnica Guerrero
Estudiante de Licenciatura en Nutrición en [UAD], Universidad Autónoma de Durango, México.
María del Carmen López Zermeño
Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, México.
Pedro Rubén Negrete López
Pasante de Lic. en Médico Cirujano y Partero, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, México.
David Pérez Becker
Estudiante de Medicina en Instituto de Ciencias de la Salud, Universidad Autónoma del Estado de Hidalgo, México.
Josefina Reynoso Vázquez
Área Académica de Farmacia y Maestría en Salud Pública, Instituto de Ciencias de la Salud, Universidad Autónoma del Estado de Hidalgo, México.
Olga Rocío Flores Chávez
Área Académica de Enfermería Instituto de Ciencias de la Salud, Universidad Autónoma del Estado de Hidalgo, México.
Jesús Carlos Ruvalcaba Ledezma *
Área Académica de Medicina y Maestría en Salud Pública, Instituto de Ciencias de la Salud, Universidad Autónoma del Estado de Hidalgo, México.
*Author to whom correspondence should be addressed.
Abstract
In the field of health economics, there are constant challenges to balance the quality of health care with efficiency in financial management, making financial models essential in the allocation of resources in the health system. The models used were Pay-for-Performance, Results-Based Budgeting and Capitation. Each model has its own focus: Pay for Performance incentivizes quality and efficiency, Results-Based Budgeting allocates resources based on health outcomes, and Capitation involves fixed payments per enrolled patient. The benefits and challenges of each model are examined, highlighting differences in levels of financial risk, equity in resource allocation, promotion of preventive care, and alignment with health care objectives. It is concluded that there is no single ideal model, and its effectiveness depends on the specific context of each health system. The importance of maintaining a patient-centered approach and promoting collaboration to find effective solutions that ensure an equitable and efficient health system is highlighted.
Keywords: Budgeting, cost management, financial models in healthcare, pay for performance, results-based capitation