SERVICES

Zeumed advises governments, public purchasers, and insurers on how healthcare systems are financed and how payment models shape behaviour across providers, patients, and care pathways. The focus is on system-level design choices that determine affordability, access, and sustainability over time.

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This work centres on the core financing and payment levers that drive real outcomes:

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• Transitions to multi-insurer or mixed financing systems
  Supporting system transitions from single-budget or single-payer models to multi-insurer or hybrid arrangements, including the design of risk pooling, benefit responsibilities, and purchasing roles to avoid fragmentation, risk selection, or cost shifting.

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• Financial protection and out-of-pocket spending
  Redesigning benefit packages and cost-sharing structures to reduce financial hardship and unmet need, while maintaining fiscal control and predictable expenditure growth.

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• Payment models and incentive design
  Designing provider payment models that align incentives with system objectives — including activity-based, bundled, population-based, and hybrid models — and assessing how changes in payment affect utilisation, substitution, and provider behaviour using econometric analysis and elasticity estimates.

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• Value-based care implemented through payment mechanisms
  Translating value-based care objectives into operational payment structures, rather than stand-alone measurement frameworks. In practice, this often involves staged approaches such as:

  • a stable base payment to protect service provision and market functioning; and

  • outcome- or performance-linked top-ups introduced progressively, informed by observed behavioural response and budget impact.
    This allows systems to test incentive effects, manage fiscal risk, and avoid disruption while shifting care delivery over time.

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• Financing high-cost and complex patient groups
  Designing funding approaches for patient groups that account for a disproportionate share of spending, where standard activity-based payments perform poorly - for example through risk pooling, carve-outs, or adjusted payment rules that protect routine service budgets.