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How to strengthen financing mechanisms to promote care for people with multimorbidity in Europe?

Struckmann V, Quentin W, Busse R, van Ginneken E
European Observatory on Health Systems and Policies
Policy Brief 24, ISSN 1997-8073


Chronic diseases are the leading cause of ill-health and death in Europe. Because of rapid population ageing, the number of people with multiple chronic conditions (multi- morbidity) will increase in all countries of Europe in the near future. These trends constitute a challenge for the financing of health and social care in terms of both mobilizing  adequate sources of funding and provider payment mecha- nisms. Payment mechanisms may support or hinder the  reorganization of care in line with the needs of people with multimorbidity. The financial incentives of different provider payment mechanisms have implications for the nature and quality of services provided. Traditionally, each care provider is paid separately, which means that there are no incentives for providers to coordinate their care, and misaligned incen- tives can create an obstacle to the implementation of inte- grated care. Therefore, the incentives of existing payment mechanisms have to be carefully evaluated when introducing integrated care programmes for people with multimorbidity.

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