China Adds Risk‑Based Payments for Tough TB Cases

In China, treating tuberculosis that resists standard drugs is harder and costs more than usual cases. Until recently, the national payment system did not account for this extra difficulty. A pilot city in 2022 changed that rule by adding a risk adjustment to its diagnosis‑intervention packet payment. The new scheme sets different reimbursement amounts for drug‑resistant TB (DR‑TB) and regular TB (DS‑TB). Researchers wanted to see whether this change made a difference. They looked at how much hospitals spent, how quickly patients finished treatment, and the overall quality of care for people with TB.The study used a quasi‑experimental design, comparing data from before and after the payment change in the pilot city. It found that hospitals received higher payments for DR‑TB cases, which helped cover the longer treatment courses and more expensive drugs. Patients treated under the new system finished their courses faster and reported fewer complications, suggesting that better funding can improve outcomes. The results point to the importance of tailoring health payments to the true cost of care, especially for diseases that are harder to treat.