China Adds Risk‑Based Payments for Tough TB Cases

Drug‑Resistant Tuberculosis Pays Off: A Pilot Study in China

Background
In China, treating drug‑resistant tuberculosis (DR‑TB) is both harder and costlier than treating regular TB. Historically, the national payment system treated all TB cases equally, ignoring these added challenges.

Policy Shift
In 2022 a pilot city introduced a risk‑adjusted payment for its diagnosis–intervention packet. Under the new scheme, hospitals receive different reimbursement levels for DR‑TB versus drug‑susceptible TB (DS‑TB).

Study Design
Researchers employed a quasi‑experimental approach, comparing hospital expenditures, treatment duration, and care quality before and after the payment change within the pilot city.

Key Findings

• Higher Reimbursements: Hospitals received increased payments for DR‑TB cases, covering longer treatment courses and pricier medications.
• Improved Patient Outcomes: Patients under the new system completed therapy faster and reported fewer complications.
• Quality of Care: The data suggest that aligning payments with actual treatment costs enhances overall care quality.

Implications
The results underscore the value of tailoring health payments to reflect true treatment costs, especially for diseases that are more difficult and expensive to manage. Adjusted reimbursement schemes can drive better clinical outcomes and more efficient use of resources.