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. 2018 Jun;5(2):98-102.
doi: 10.7861/futurehosp.5-2-98.

Paying for what matters most: the future of outcomes-based payments in healthcare

Rupert Dunbar-Rees  1
Affiliations

Paying for what matters most: the future of outcomes-based payments in healthcare

Rupert Dunbar-Rees. Future Healthc J. 2018 Jun.

Abstract

Payment by results' (PbR) is probably one of the most widely debated misnomers in the NHS. At best, rather than reimbursing results, it can be considered as payment for providing collections of acute care activities. Better prevention is often cited as the only solution to sustainability, but currencies which reward prevention seemingly remain very hard to create. This review article explores the impact of legacy payment systems on health and care systems nationally and internationally. It examines alternative models, such as payment for outcomes, and questions whether any alternative payment systems may better support prevention, and finally achieve the 'holy grail' of a truly sustainable care system. If payment for outcomes offers a potential solution, then what are the key barriers and enablers? The case for alternative, novel metrics for success is proposed, which may better support care systems to measure their progress towards sustainability than existing indicators.

Keywords: Sustainability; capitation; healthcare outcomes; novel payment models; reimbursement.

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Figures

Fig 1.
Fig 1.
‘What we pay for now’ Outcomes Based Healthcare slide. Adapted with permission from the following presentation at Digital Health Live, 5 May 2015, Dubai: Dunbar-Rees R, Hafezparast N. Reimbursement models that can enable the rapid advances happening in healthcare. Outcomes Based Healthcare, 2015.
Fig 2.
Fig 2.
‘What we need – new health currencies’ Outcomes Based Healthcare slide. Adapted with permission from the following presentation at Digital Health Live, 5 May 2015, Dubai: Dunbar-Rees R, Hafezparast N. Reimbursement models that can enable the rapid advances happening in healthcare. Outcomes Based Healthcare, 2015.
See this image and copyright information in PMC

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