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Payment by Results

Payment by Results. www.russellwebster.com Twitter: @russwebt. Payment by Results. Demystify PbR Brief overview Resources Plans A, B, C…. Scalability. Black Box. Binary or Frequency. Creaming & Parking. Differential Pricing. Financial Cliff Edge. Cashable Savings. Market Warming.

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Payment by Results

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  1. Payment by Results www.russellwebster.com Twitter: @russwebt

  2. Payment by Results Demystify PbR Brief overview Resources Plans A, B, C…

  3. Scalability Black Box Binary or Frequency Creaming & Parking Differential Pricing Financial Cliff Edge Cashable Savings Market Warming Risk Transfer

  4. What PBR is Best practice/Outcome commissioning Should foster innovation and best practice Provider independence #blackbox Result determined by paymaster Criminal Justice System = Reduction of re-offending DWP = Off incapacity benefit and into work Troubled Families = less children in care

  5. What PBR isn’t… The DoH model Paying by activity since 2003/4 (provider income = activity x price) About costs and efficiency Not patient outcomes Contract management Penalty clause Payment by outputs But milestones etc.

  6. In theory Commissioner decides outcomes Commissioner decides how outcomes will be measured & verified Risk transferred from Government/Commissioner Payment only on success Should stimulate innovation

  7. In practice It is hard to transfer all the risk Providers can’t/wont work for free for 5 years Partial schemes much more common Cashable savings difficult in criminal justice system Argument over milestones, frequency v binary Therefore, Innovation rare as Risk high.

  8. Audit Commission Principles NO evidence base, so no clear recommendations but 5 key principles: ONE clear purpose A full understanding of risks Pay attention to payment & reward structure Sound financing for whole scheme Effective & robust measurement & evaluation

  9. Resources Audit Commission: Local Payment by Results www.russellwebster.com Twitter: @russwebt Linked in Payment by results group

  10. Explore PbR from commissioners’ & providers’ POV

  11. What have we learnt about PbR from the Work Programme?

  12. Q & A

  13. ??

  14. Lessons from the Work Programme It is too early to say but… All providers missed targets Job outcomes very expensive Despite long lead-in time “Killing zone” for voluntary sector

  15. Lessons from the Work Programme Massive reputational hit Targets set pre-double-dip Experts say local commissioning would help Performance will improve… …But by how much

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