SavedAdd your journal

Journals / Sosyoekonomi / 2026 / Cilt: 34 Sayı: 69

A Qualitative Research on The Applicability of Value-Based Payment Method in The Health System of Türkiye

Değer Bazlı Geri Ödeme Yönteminin Türkiye Sağlık Sisteminde Uygulanabilirliği Üzerine Nitel Bir Araştırma

Merve Tekinarslan(GÜMÜŞHANE ÜNİVERSİTESİ)0000-0002-1054-0946
Sıdıka Kaya(YÜKSEK İHTİSAS ÜNİVERSİTESİ)0000-0002-1495-9373
Pages
453–471
Publication Date
2026-07-31
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

The study recommends addressing resistance to change and implementing necessary revisions for Türkiye to adopt this model successfully.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:This study explores value-based payment reforms in healthcare, aiming to enhance productivity, efficiency, and quality of care by shifting the focus from quantity to value.
📊
Key Findings & Data:Using a grounded theory approach and the Delphi technique, 28 healthcare stakeholders were selected through purposive sampling.
💡
Conclusion & Impact:The study recommends addressing resistance to change and implementing necessary revisions for Türkiye to adopt this model successfully.
🔬Design:Modeling & Simulation
📍Scope:2020 Verileri
⚙️Variables:Değer Esaslı Geri Ödeme · Sağlıkta Değer · Değer Esaslı Sağlık Hizmeti

Abstract

This study explores value-based payment reforms in healthcare, aiming to enhance productivity, efficiency, and quality of care by shifting the focus from quantity to value. Using a grounded theory approach and the Delphi technique, 28 healthcare stakeholders were selected through purposive sampling. Data were analysed with MAXQDA 2020, and value parameters were ranked by importance. Findings define value in healthcare as "a quality service," with participants supporting value-based repayment despite some limitations. Fifteen key value measurement parameters were identified. The study recommends addressing resistance to change and implementing necessary revisions for Türkiye to adopt this model successfully.

Özet

Bu çalışma, odağı nicelikten değere kaydırarak üretkenliği, verimliliği ve bakım kalitesini artırmayı amaçlayan sağlık hizmetlerinde değere dayalı ödeme reformlarını incelemektedir. Temellendirilmiş teori yaklaşımı ve Delphi tekniği kullanılarak, 28 sağlık sektörü paydaşı amaçlı örnekleme yoluyla seçilmiştir. Veriler MAXQDA 2020 ile analiz edilmiş ve değer parametreleri önem sırasına göre düzenlenmiştir. Bulgular, sağlık hizmetlerinde değeri "kaliteli bir hizmet" olarak tanımlamaktadır ve katılımcılar, bazı sınırlamalara rağmen, değere dayalı geri ödemeyi desteklemektedir. On beş temel değer ölçüm parametresi belirlenmiştir. Çalışma, Türkiye’nin bu modeli başarılı bir şekilde benimsemesi için değişime karşı direncin ele alınmasını ve gerekli revizyonların uygulanmasını önermektedir.

🔖

Cite This Article

Tekinarslan, M., Kaya, S. (2026). A Qualitative Research on The Applicability of Value-Based Payment Method in The Health System of Türkiye. Sosyoekonomi, Cilt: 34 Sayı: 69, 453–471. https://doi.org/10.17233/sosyoekonomi.2026.03.21

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (95)

  1. Ağlamış, M. (2020), “Sağlık Hizmetlerinde Değere Dayalı Satın Alma ve Değere Dayalı Geri Ödeme Yöntemi: Dünya ve Türkiye”, Selçuk Sağlık Dergisi, 1(1), 25-36.
  2. Alsleben, A.J. (2016), Data Analytics Role in Population Health Management, The College of St. Scholastica, ProQuest Number: 10125300.
  3. Aroh, D. et al. (2015), “An Example of Translating Value-Based Purchasing into Value-Based Care”, Urologic Nursing, 35(2), 61-74.
  4. Austin, J.M. et al. (2015), “National Hospital Ratings Systems Share Few Common Scores and May Generate Confusion Instead of Clarity”, Health Affairs, 34(3), 423-430.
  5. Baltacı, A. (2019), “Nitel Araştırma Süreci: Nitel Bir Araştırma Nasıl Yapılır?”, Ahi Evran Üniversitesi Sosyal Bilimler Enstitüsü Dergisi, 5(2), 368-388.
  6. Bergstrom, T. (2015), A Simplified Guide to Value-Based Reimbursement, For Nursing Facilities (First Edition), Care Providers of Minnesota.
  7. Boden, W. & R. Redberg (2018), “Evolving from Volume to Value, Or to A Bolder Vision of Reimbursement Reform?”, American Heart Journal, 204, 174-177.
  8. Brantes, F.D. et al. (2010), “Bundled and feefor- episode payments: An example”, in: P.L. Young et al. (eds.), The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary (370-376), National Academies Press. Washington D.C.
  9. Braun, V. & V. Clarke (2006), “Using Thematic Analysis in Psychology”, Qualitative Research in Psychology, 3(2), 77-101.
  10. Brooks, J.A. (2016), “Understanding Hospital Value-Based Purchasing”, American Journal of Nursing, (116), 63-66.
  11. Burgess, N. & Z. Radnor (2013), “Evaluating Lean in Healthcare”, International Journal of Health Care Quality Assurance, 26(3), 220-235.
  12. Cashin, C. (2015), Assessing Health Provider Payment Systems: A Practical Guide for Countries Working Toward Universal Health Coverage, Joint Learning Network for Universal Health Coverage, Washington, DC.
  13. Casto, A.B. & E. Layman (2006), Principles of Healthcare Reimbursement, Michigan: American Health Information Management Association.
  14. Chambers, J.D. et al. (2015), “Medicare Is Scrutinizing Evidence More Tightly for National Coverage Determinations”, Health Affairs, 34(2), 253-260.
  15. Charmaz, K. & L.L. Belgrave (2015), “Grounded Theory”, in: G. Ritzer (ed.), The Blackwell Encyclopedia of Sociology,, 11.02.2020.
  16. CMS (2020), “The Hospital Value-Based Purchasing (VBP) Program”,, 04.01.2021.
  17. CMS (2021), “The Hospital Value-Based Purchasing (VBP) Program”,, 27.06.2021.
  18. Cohen, R.V. et al. (2021), “Surgical Management of Obesity in Brazil: Proposal for A Value-Based Healthcare Model and Preliminary Results”, Value in Health Regional Issues, 26, 10-14.
  19. Counts, N.Z. et al. (2021), “The Need For New Cost Measures in Pediatric Value-Based Payment”, Pediatrics, 147(2), e20194037.
  20. Custers, T. et al. (2007), “Is There a Business Case for Quality in The Netherlands?: A Critical Analysis of The Recent Reforms of The Health Care System”, Health Policy, 82(2), 226-239.
  21. Damberg, C. & R. Reid (2020), “Where Are We in The Transition to Value‐Based Payments? Findings From A Study on Health System Physician Compensation Arrangements and Financial Incentives for Performance”, Health Services Research, 55(1), 126-126.
  22. Damberg, C.L. et al. (2014), “Measuring Success in Health Care Value-Based Purchasing Programs: Findings from an Environmental Scan, Literature Review, and Expert Panel Discussions”, RAND Corporation Research Report.
  23. Deniz, M.H. & E.H. Hobikoğlu (2011), “Türkiye’de Değere Bağlı Sağlık Sistemi Temelinde Kamu ve Özel Sektör Açısından Algılanan Hizmet Kalitesi”, International Conference on Eurasian Economies (160-166).
  24. Dlugacz, Y.D. (2009), Value-Based Health Care: Linking Finance and Quality, John Wiley & Sons.
  25. Dor, A. et al. (2015), “Medicare’s Hospital Compare Quality Reports Appear to Have Slowed Price Increases for Two Major Procedures”, Health Affairs, 34(1), 71-77.
  26. Durur, F. (2020), Sağlık Çalışanlarında Yalın Yönetim, Ankara, Turkey: İksad Publishing House.
  27. Eijkenaar, F. et al. (2013), “Effects of Pay for Performance in Health Care: A Systematic Review of Systematic Reviews”, Health Policy, 110(2-3), 115-130.
  28. Elf, M. et al. (2017), “The Case of Value-Based Healthcare for People Living with Complex Long-Term Conditions”, BMC Health Services Research, 17(1), 1-6.
  29. European Society of Radiology (ESR) (2021), “Patient Survey of Value in Relation to Radiology: Results from A Survey of the European Society of Radiology (ESR) Value-Based Radiology Subcommittee”, Insights into Imaging, 12(6), https://doi.org/10.1186/s13244-020-00943-x.
  30. Fendrick, A.M. et al. (2010), “Applying Value-Based Insurance Design to Low-Value Health Services”, Health Affairs, 29(11), 2017-2021.
  31. Geels, F.W. (2002), “Technological Transitions as Evolutionary Reconfiguration Processes: A Multi-Level Perspective and A Case Study”, Research Policy, 31(8/9), 1257-1274.
  32. Godman, B. & L.L. Gustafsson (2013), “A New Reimbursement System for Innovative Pharmaceuticals Combining Value-Based and Free Market Pricing”, Applied Health Economics and Health Policy, 11(1), 79-82.
  33. Greenfield, B. et al. (2020), “The Ethics of Value-Based Payment in Physical Therapy Models: Physical Therapy Experts Take a Look at Some Issues That Must Be Considered in The Movement to Value-Based Payment Models”, APTA Magazine, 12(6), 36.
  34. Gustavsson, S. et al. (2016), “Using An Adapted Approach to The Kano Model to Identify Patient Needs from Various Patient Roles”, TQM Journal, 28(1), 151-162.
  35. Güvercin, A. et al. (2016), “Sağlık Hizmetlerinin Finansmanı ve Sosyal Güvenlik Kurumu”, Bartın Üniversitesi İİBF Dergisi, 7(13), 80-94.
  36. Hillary, W. et al. (2016), “Value-Based Healthcare”, Advances in Management, 9(1), 1.
  37. IOM (Institute of Medicine) (2010), “The Healthcare Imperative: Lowering Costs and Improving Outcomes”, Workshop Series Summary, The National Academies Press.
  38. Izguttinov, A. et al. (2020), “From Volume- To Value-Based Payment System in Washington State Federally Qualified Health Centers”, Journal of Ambulatory Care Management, 43(1), 19-29.
  39. Jegers, M. et al. (2002), “A Typology for Provider Payment Systems in Health Care”, Health Policy, 60(3), 255-273.
  40. Johnson, D.C. et al. (2019), “Financial Margins for Prostate Cancer Surgery: Quantifying the Impact of Modifiable Cost Inputs in an Episode-Based Reimbursement Model”, Journal of Urology, 202(3), 539-545.
  41. Joseph, S. (2017), “Transitioning From Fee-For-Service to Value-Based Health Care Model”, Utica College, ProQuest Dissertations Publishing, 10260282.
  42. Kamae, I. (2010), “Value-Based Approaches to Healthcare Systems and Pharmacoeconomics Requirements in Asia”, PharmacoEconomics, 28(10), 831-838.
  43. Karacaoğlan, N. (2019), Sağlık Hizmet Sunucularına Ödeme Modelleri ve Sorunlar, Sağlık Düşüncesi ve Tıp Kültürü Platformu.
  44. Kasapoğlu, A. (2016), “Türkiye’de Sağlık Hizmetlerinin Dönüşümü”, Journal of Sociological Research, 19(2), 131-174.
  45. Koç, O. (2017), “Sağlık Sisteminde Ödeme Mekanizmaları”, Sağlık Düşüncesi ve Tıp Kültürü Dergisi, 42, 70-73.
  46. Kolarczyk, L.M. et al. (2018), “Defining Value-Based Care in Cardiac and Vascular Anesthesiology: The Past, Present, and Future of Perioperative Cardiovascular Care”, Journal of Cardiothoracic and Vascular Anaesthesia, 32(1), 512-521.
  47. Kuckartz, U. & S. Rädiker (2021), “Using MAXQDA for mixed methods research”, in: The Routledge reviewer’s guide to mixed methods analysis (305-318), Routledge.
  48. Kuhn, B. & C. Lehn (2015), “Value-Based Reimbursement: The Banner Health Network Experience”, Frontiers of Health Services Management, 32(2), 17-31.
  49. Kurutkan, M.N. & M. Bayat (2015), “Değer Bazlı Satın Alma ve Geri Ödeme Sistemi Açısından Hastane Kaynaklı Durumlar”, Health Care, 2(3), 155-164.
  50. Lakdawalla, D.N. et al. (2018), “Defining Elements of Value in Health Care-A Health Economics Approach: An ISPOR Special Task Force Report [3]”, Value in Health, 21(2), 131-139.
  51. Lee, K.K. et al. (2016), “Developing A Measure of Value in Health Care”, Value in Health, 19(4), 323-325.
  52. MacLean, C. (2017), “Value-Based Purchasing for Osteoarthritis and Total Knee Arthroplasty: What Role for Patient-Reported Outcomes?”, Journal of the American Academy of Orthopaedic Surgeons, 25(1), 55-59.
  53. McIntyre D. & J. Kutzin (2016), Health Financing Country Diagnostic: A Foundation for National Strategy Development, Geneva: World Health Organization, Health Financing Guidance No 1.
  54. McWilliams, J.M. et al. (2018), “Medicare Spending After 3 Years of The Medicare Shared Savings Program”, N Engl J Med, 379(12), 1139-1149.
  55. Morris, C. & K. Bailey (2014), “Measuring Health Care Quality: An Overview of Quality Measures”, Health System Improvement Issue Brief, May.
  56. Mossialos, E. & A. Dixon (2002), “Funding Health Care: An Introduction”, in: E. Mossialos et al. (eds.), Funding Health Care: Options for Europe (1-30), Buckingham & Philadelphia: Open University Press.
  57. NEJM Catalyst (2017), What Is Value-Based Healthcare?,, 25.05.2025.
  58. O’Grady, M.A. et al. (2020), “How Are Substance Use Disorder Treatment Programs Adjusting to Value-Based Payment? A Statewide Qualitative Study”, Substance Abuse Research and Treatment, 14, 1-10.
  59. Özsarı, S.H. (2021), “Değer Temelli Sağlık Hizmeti”, Türkiye Sağlık Enstitüleri Başkanlığı Dergisi, 4(2), 48-53.
  60. Philips (2019), “Value-Based Care: Turning Healthcare Theory Into A Dynamic and Patient-Focused Reality”, Philips Position Paper,, 20.05.2019.
  61. Porter, M.E. & R.S. Kaplan (2016), “How To Pay For Health Care”, Harvard Business Review, 94(7/8), 88-98.
  62. Porter, M.E. (2010), “What Is Value In Health Care?”, The New England Journal of Medicine, 363(26), 2477-2481.
  63. Porter, M.E. (2014), “Value-Based Health Care Delivery”, Partners Healthcare, Value-Based Health Care Seminar, Harvard Business School.
  64. Roberts, M. et al. (2004), Getting Health Reform Right: A Guide to Improving Performance and Equity,, 30.05.2020.
  65. Rudmik, L. et al. (2014), “Productivity Costs in Patients With Refractory Chronic Rhinosinusitis”, The Laryngoscope, 124(9), 2007-2012.
  66. Schuttner, L. et al. (2020), “Değer Bağlamında Kalite”, American Journal of Medical Quality, 35(6), 465-473.
  67. Şen, F. (2017), Sağlıkta Yeni Dönem: “Değer Bazlı Sağlık” Hizmetleri Ödenecek,, 30.12.2019.
  68. Seyfioğlu, F. (2019), “Değer Temelli Sağlık Hizmetleri Modeli”, Hacettepe Sağlık İdaresi Dergisi, 22(4), 799-822.
  69. Şimşir, İ. & S. Altındiş (2019), “Could Value-Based Purchasing Approach Be Used in Assessment of Healthcare Delivery Outputs?”, Konuralp Medical Journal, 11(3), 475-481.
  70. Sorenson, C. et al. (2013), “Evolving Reimbursement and Pricing Policies for Devices in Europe and the United States Should Encourage Greater Value”, Health Affairs, 32(4), 788-796.
  71. T.C. Kalkınma Bakanlığı (2014), 10. İhtisas Kalkınma Planı, Sağlık Hizmetlerinin Etkinliğinin Artırılması ve Mali Sürdürülebilirlik Özel Komisyonu Raporu, No: KB: 2904- ÖİK: 743, Ankara.
  72. T.C. Kalkınma Bakanlığı (2018), 11. Kalkınma Planı (2019-2023), Sağlık Hizmet Kalitesi ve Mali Sürdürülebilirlik, Özel İhtisas Komisyonu Raporu, Ankara.
  73. Tatar, M. (2017), “İlaçta Fiyatlandırma ve Geri Ödeme Politikalarında Değer Kavramı”, Sağlık Ekonomisi ve Politikası Çalışmaları - 1,, 02.03.2025.
  74. Top, M. & M. Tarcan (2007), “Hastane Sektöründe Kaynak Akışı: Hastane Ödeme Yöntemleri (Mekanizmaları)”, Gazi Üniversitesi İ.İ.B.F. Dergisi, 9(1), 169-189.
  75. Toussaint, J.S. & L.L. Berry (2013), “The Promise of Lean in Health Care”, Mayo Clinic Proceedings, 88(1), 74-82.
  76. Trautman, D.E. (2011), “Healthcare Reform: 1 Year Later”, Nursing Management, 42(4), 26-31.
  77. Tutar, F. & N. Kılınç (2007), “Türkiye’nin Sağlık Sektöründeki Ekonomik Gelişmişlik Potansiyeli ve Farklı Ülke Örnekleriyle Mukayesesi”, Afyon Kocatepe Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi, 9(1), 31-54.
  78. Urick, B.Y. (2016), Assessing The Relationship between Pharmacy Quality and Healthcare Cost for A Commercially Insured Population, The University of Iowa.
  79. Vollstedt, M. & S. Rezat (2019), “An Introduction to Grounded Theory with A Special Focus on Axial Coding and The Coding Paradigm”, in: G. Kaiser & N. Presmeg (eds.), Compendium for Early Career Researchers in Mathematics Education (81-100), ICME-13 Monographs, Springer.
  80. Werner, R.M. et al. (2021), “The Future of Value-Based Payment: A Road Map To 2030”, White Paper, Leonard Davis Institute of Health Economics.
  81. Woods, D.J. (2016), “Impacts Of Pay-For-Value on Healthcare Providers, Health Plans and Patients-New Reimbursement Models Promise Higher Quality and Lower Cost”, Doctoral Thesis, Utica College.
  82. Woolhveler, S. & D.U. Himmelstein (2014), “Administrative Work Consumes One-Sixth of US Physicians’ Working Hours and Lowers Their Career Satisfaction”, International Journal of Health Services, 44(4), 635-642.
  83. World Health Organization (2008), Health Systems Financing,, 3.3.2019.
  84. Yıldırım, A. & H. Şimşek (2008), Sosyal Bilimlerde Nitel Araştırma Yöntemleri, Ankara: Seçkin Yayıncılık.
  85. Yıldırım, H. et al. (2021), “Value-Based Healthcare: The Turkish Case”, Türkiye Sağlık Enstitüleri Başkanlığı Dergisi, 4(1), 33-48.
  86. Zuckerman, R.B. et al. (2016), “Readmissions, Observation, and The Hospital Readmissions Reduction Program”, N Engl J Med, 374, 1543-1551.
  87. Charmaz, K. & L.L. Belgrave (2015), “Grounded Theory”, in: G. Ritzer (ed.), The Blackwell Encyclopedia of Sociology,, 11.02.2020.
  88. CMS (2020), “The Hospital Value-Based Purchasing (VBP) Program”,, 04.01.2021.
  89. CMS (2021), “The Hospital Value-Based Purchasing (VBP) Program”,, 27.06.2021.
  90. NEJM Catalyst (2017), What Is Value-Based Healthcare?,, 25.05.2025.
  91. Philips (2019), “Value-Based Care: Turning Healthcare Theory Into A Dynamic and Patient-Focused Reality”, Philips Position Paper,, 20.05.2019.
  92. Roberts, M. et al. (2004), Getting Health Reform Right: A Guide to Improving Performance and Equity,, 30.05.2020.
  93. Şen, F. (2017), Sağlıkta Yeni Dönem: “Değer Bazlı Sağlık” Hizmetleri Ödenecek,, 30.12.2019.
  94. Tatar, M. (2017), “İlaçta Fiyatlandırma ve Geri Ödeme Politikalarında Değer Kavramı”, Sağlık Ekonomisi ve Politikası Çalışmaları - 1,, 02.03.2025.
  95. World Health Organization (2008), Health Systems Financing,, 3.3.2019.