News / Report spells out payment plans

NHS England and Monitor have raised the possibility of introducing different efficiency expectations for acute providers in 2015/16.

In a document outlining their thinking on developing the NHS payment system in 2015/16 and beyond, NHS England and the sector regulator said they were considering a more sophisticated method for estimating providers’ potential to improve their efficiency.

The report said providers may be considered in peer groups, or the tariff could apply distinct efficiency factors for different types of care.

The two organisations are also considering measures to control the growth of spending.

Areas of high activity and spending growth, together with the range of variation between providers, are being identified. This could lead to changes in national prices or variation rules.

Action to contain acute providers’ income growth for services without national prices is also being considered.

How Monitor and NHS England are working to make the payment system do more for patients from 2015/16 said a number of options were on the table as the organisations sought to use the tariff to promote changes to patterns of care, including the new system of urgent and emergency care.

Guidance could be developed to allow local health economies to share financial accountability for patient outcomes and costs.

This could be through whole person capitation and payment based on outcomes for defined populations.

In particular, the bodies would like to see this for patients who benefit from coordinated and proactive care, such as those with multiple comorbidities and the frail and elderly.

Other areas being considered include steps to better reflect cost in prices and provide intelligence for local price setting.