OBJECTIVES: Adoption of outcomes-based agreements (OBAs) is important for any health care reform. Algerian payers need OBAs to stratify populations and identify specific interventions that can improve patient outcomes. In Kingdom of Saudi Arabia (KSA), the use of OBAs is expanding (22 ongoing OBAs). The OBAs conducted in KSA by Ministry of Health (MoH) and renewed every 3 years after settling the price controlled by NUPCO. Algeria is eager to learn from Saudi development experience. The aim of this study was to identify the challenges and the recommendations for implementation of OBAs in Algeria.

METHODS: A focus group was formed as a national initiative activity by the Algerian government and three representative authorities in KSA: MoH, NUPCO and National Guard Health Affairs. This group consisted of various policy makers with experience in health economics, outcomes research, public health, and health policy. Both Saudi and Algerian parties held in-depth discussions and identified the challenges and the recommendations for OBAs implementation in Algeria.

RESULTS: The focus groups agreed that the main challenges in OBAs implementation were reliance on traditional payment models, complexity in regulatory system, lack of healthcare infrastructure and gaps in operational capability. The two key recommendations that could help in OBAs implementation are building capabilities of policy makers in health economics to focus on outcomes that matter to ensure health system efficiency, and establishment an effective policy ecosystem for building robust data infrastructure to enable measurement of costs and outcomes in a transparent way.

CONCLUSIONS: OBAs based on mortality event reduction, hospitalization reduction, and other outcomes that could be tracked with health system is a win for all stakeholders leading to healthier lives, improve the quality of care, and lower healthcare costs. The two countries agreed to make concerted efforts in expanding mutual cooperation in the implementation of OBAs in Algeria.