Financing & reimbursement Care@Home
Care@Home enables hospital-equivalent care in patients' own homes. The project examines financing and reimbursement models to sustainably integrate this innovative form of care into the Swiss healthcare system.
Factsheet
- Schools involved School of Health Professions
- Institute(s) Institute of Health Economics and Health Policy
- Funding organisation BFH
- Duration (planned) 01.01.2025 - 31.12.2025
- Head of project Prof. Dr. Katharina Blankart
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Project staff
Daniel Ammann
Dr. Maryna Ivets - Keywords Integrated Care; Health Economics; Health Services Research
Situation
Since 2021, new care models have been emerging in Switzerland that enable hospital-equivalent treatments at home - known as Care@Home (CaH) models. These combine hospital services with outpatient care and nursing during acute illness phases. Currently, these innovative care models are exclusively financed through pilot projects. For sustainable integration into the Swiss healthcare system, there is currently no unified understanding of which services qualify as CaH and how they should be appropriately reimbursed. The existing reimbursement systems - case-based payments in hospitals, fee-for-service in outpatient care, and nursing minutes for home care - inadequately reflect the complex care situation of CaH patients. A central challenge is therefore the development of sustainable financing and reimbursement structures that ensure high-quality and cost-efficient care.
Course of action
The project analyzes Care@Home financing and reimbursement through a combination of literature review, stakeholder interviews, and quantitative analysis of service data. Using selected treatment episodes, the costs and scope of services across different care models - from hospital-centered to Spitex-centered - are systematically recorded and compared with traditional hospital care. The findings will be incorporated into a policy brief that formulates recommendations for sustainable financing of Care@Home in the Swiss healthcare system.
Looking ahead
The project results will significantly contribute to integrating CaH into the Swiss healthcare system. The developed framework enables service providers and payers to evaluate how CaH services can be adequately reimbursed and sustainably financed. Identified gaps in existing reimbursement schemes can serve as a basis for necessary adjustments. The project creates the foundation for developing innovative reimbursement instruments that intelligently combine tariffs from inpatient and outpatient services for CaH care episodes, for example through bundled payments. Additionally, an evaluation concept will be developed that assesses the effectiveness and efficiency of CaH models based on the quadruple aim of healthcare: care experience, population health, cost efficiency, and staff working conditions. The findings will make an important contribution to the evolution of the Swiss healthcare system and pave the way for patient-oriented, high-quality acute care at home.
