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Payment by Results

What we know about payment by results

This final post summarises the most important lessons to bear in mind if you are involved in commissioning, investing in or providing a payment by results-funded scheme.

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The unexpected consequences of payment by results

The issue of providers “gaming” PbR contracts is a hot issue in the literature. Commentators take different views with some stating that it is only rational and efficient for providers to focus on the outcomes incentivised by PbR payments to the best of their ability while others describe similar behaviour as “gaming.”

Payment by Results

Getting payment by results contracts right

Designing PbR contracts can be a tricky business with plenty of examples in the literature of commissioners and providers wishing they had never signed on the dotted line. In addition to getting the outcomes and payment incentives right, two issues are particularly critical: the overall length of the contract and the he delay until, and interval between, incentive payments.

Payment by Results

Quality assurance in payment by results contracts

The main message from the literature is that commissioners need to be proactive in ensuring that PbR providers deliver a good quality service — particularly when service users include vulnerable groups

Payment by Results

Attributing outcomes in payment by results contracts

When outcomes are the basis for payment, it is important that the provider receiving the payments is responsible for achieving the outcomes. Targets should not be unduly influenced by external factors (such as the state of the economy for Work Programme type schemes) or by the work of other agencies who are not receiving payment from the contract.

Payment by Results

Verifying outcomes for payment by results

Latest post in a series examining the lessons from the payment by results research literature focuses on the importance of verifying outcomes.

Payment by Results

Getting the right outcomes for payment by results

Not only do outcomes therefore have to be accurate and realistic but commissioners need to consider that providers will quite reasonably de-prioritise work which is not governed by an outcome.

Payment by Results

Understanding the market for payment by results

commissioners are urged to consider whether potential providers have sufficient financial resources to bid for a contract which requires considerable initial investment and where payments are delayed until the achievement of outcome measures has been verified.

Payment by Results

Can payment by results transfer risk?

It is not possible to transfer all risk, be that risk reputational, practical or financial. Commissioners retain their responsibility for local citizens receiving a good quality and effective service.

Payment by Results

Can payment by results stimulate innovation?

 PbR and innovation This is the fifth post in a blog series looking at the lessons I’ve learned from a recent review of the payment by results literature.

Payment by Results

Can payment by results save money?

Latest post in Payment by Results: Lessons from the Literature series examines what the research tells us about PbR’s capacity to save public money.

Payment by Results

Can payment by results improve outcomes?

The idea is that by commissioning outcomes rather than outputs, commissioners allow provider to work in any way they see fit, safe in the knowledge that if the outcomes are not achieved, they do not have to make payment. But do PbR schemes achieve better outcomes?

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