CCG alert: capitation

Showing posts with label capitation. Show all posts

25 September 2017

A retrospective cross-sectional study of general practices in England, 2014–2015 explored associations between practice funding (capitation payments and supplements) and secondary care usage, patient satisfaction, and clinical outcomes (QOF scores).
Capitation payments appear to be broadly aligned to patient need in terms of secondary care usage. Supplements to the current capitation formula are associated with reduced secondary care costs.

New payment approaches will be needed to support local health and care economies to make the rapid shift to payment approaches that will underpin new care models.
This page brings together documents around

the background to reforming the NHS payment system,
capitation as an example of a potential new payment model to enable integrated care
mulilateral gain/loss sharing, a local payment example which enables finances to be reallocated across a local care economy when delivering new care models.
Improving Access to Psychological Therapies payment
Outcomes-based payment for mental healthcare
3-part payment for urgent and emergency care

"A capitated payment or capitation means paying a provider or group of providers to cover the majority (or all) of the care provided to a target population, such as patients with multiple long term conditions (LTCs), across different care settings."p3
This document describes:

Improvements to the payment system for healthcare will be critical to developing and delivering the new care models described in the Five Year Forward View, alongside changes in other enablers such as contracting, technology and the workforce.
The use of so-called ‘capitation’ payments to NHS providers- bringing hospitals, community and mental health into line with the way GPs are funded – would particularly benefit the frail elderly and those with multiple care needs, such as those with long-term conditions. (See Supporting innovation in the NHS with local payment arrangements)
Monitor and NHS England are encouraging commissioners and providers to adopt this new payment model when negotiating the local price-setting arrangements. The organisations propose such arrangements should increasingly become the norm under reforms to the national tariff, which would see it become a framework of rules, rather than just a list of prices.

This document explains how NHS providers and commissioners can use capitated payment arrangements to support local service improvement and reconfiguration as permitted under the Health and Social Care Act 2012.
The document describes:

Capitated payment or capitation means paying a provider or group of providers to cover the majority (or all) of the care provided to a target population, such as patients with multiple long term conditions, across different care settings. The regular payments are calculated as a lump sum per patient.