Performance-based risk-sharing agreements in renal care: current experience and future prospects

Mike Drummond, Carlo. Federici, Ellen Busink, Christian Apel, Dana Kendzia, W.B.F. Brouwer

Research output: Contribution to conferencePaperpeer-review


Introduction: Performance-based risk -sharing agreements (PBRSAs), between payers, health care providers, and technology manufacturers can be useful when there is uncertainty about the (cost-) effectiveness of a new technology or service. However, they can be challenging to design and implement.

Areas covered: A total of 18 performance-based agreements were identified through a literature review. All but 2 of the agreements identified were pay-for-performance schemes, agreed between providers and payers at the national level. No examples were found of agreements between healthcare providers and manufacturers at the local level. The potential for these local agreements was illustrated by hypothetical case studies of water quality management and an integrated chronic kidney disease programme.

Expert opinion: Performance-based risk-sharing agreements can work to the advantage of patients, health care providers, payers, and technology manufacturers, particularly if they facilitate the introduction of technologies or systems of care that might not have been introduced otherwise. However, the design, conduct, and implementation of PBRSAs in renal care pose a number of challenges. Efforts should be made to overcome these challenges, so
that more renal care patients can benefit from technological advances and new models of care.
Original languageEnglish
Number of pages1
Publication statusPublished - 12 Jan 2021

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