Effects of Payment by Results on Primary Care Commissioning and New Provider Services
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1 Effects of Payment by Results on Primary Care Commissioning and New Provider Services Dr Tim Richardson
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Effects of Payment by Results on Primary Care Commissioning and New Provider Services. Dr Tim Richardson. THE NHS PLAN / WHITE PAPER “Care out of Hospital” 2006-2008. More services in Primary/Community Care Specialist Clinics Therapies Diagnostics / Day Surgery Chronic Disease Management. - PowerPoint PPT Presentation
Transcript of Effects of Payment by Results on Primary Care Commissioning and New Provider Services
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Effects of Payment by Results on Primary Care Commissioning
and New Provider Services
Dr Tim Richardson
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THE NHS PLAN / WHITE PAPER “Care out of Hospital” 2006-2008
More services in Primary/Community Care Specialist Clinics Therapies Diagnostics / Day Surgery Chronic Disease Management
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LEVERS FOR CHANGE
PBR – Tariffs PBC – Will it Happen? Patient CHOICE New Healthcare Contracts New Providers
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NEW CONTRACTS / NEW PROVIDERS
Specialist Personal Medical Cervices (SPMS) Alternative Provider of Medical Services
(APMS) Independent Sector Treatment Centres
(ISTCs)
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NECESSARY INPACT ON ACUTE PROVIDERS
Concentration of Critical Care Larger Populations Covered Fewer Acute Cost Centres Improved Clinical Quality and Training
Opportunities
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PROBLEMS WITH PBR / PBC
Total Costs of Current Activity Greater than Budgets
Market Forces Factor – Withholding Centrally
Top Slicing of PCT / PBC Budgets
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WHAT NEEDS TO BE DONE?
If PBC is to generate “Care Out of Hospital” then appropriate level budgets with minimum Top-Slicing or with-holding MFF, is essential, otherwise where are the incentives?
New providers can and will offer services at below acute care HRG tariffs, but not at the baseline tariff.
To reach financial balance means either rationing care or providing it more cost effectively.
