Integrated budgets


The Five Year Forward View aims to give people access to more integrated care and support a more efficient service. Changing the way we pay for services delivered through new care models is a key enabler in delivering this integration and efficiency.

Accountable care organisations, including multispecialty community providers and primary and acute care systems, are new care models set out in the Five Year Forward View. An integrated budget payment approach, sometimes referred to as a whole population budget, is thought to be an effective and practical way of implementing integrated care models of this type, as a first step towards capitated budgets.

The integrated budget payment approach is characterised by the following features:

  • covers the relevant service scope for the whole population 
  • removes the direct relationship between activity and payment 
  • improves alignment of payment for all providers within the care model 
  • better incentivises prevention and wellbeing
  • focuses on management of outcomes, activity and costs across the system

Alongside NHS England we are working with a number of sites that are implementing new care models, to demonstrate how the constituent parts of a whole population budget can be developed at pace. 

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Capitation: context and vision
Provides the context for payment development and overviews of capitated payments and whole population budgets; the building blocks needed for making progress with payment development, and transition and shadow testing. 

Capitation/ whole population budgets: population, scope and new care models
Provides an overview of process to scope your services and population for a whole population budget. This includes bringing your population, scope and new care model together, with insights from payment trail blazer vanguards. 

Capitated/ whole population budgets: determining the budget
Learn more about the principles and methodology for determining your whole population budget. 

Capitated/ whole population budgets: gain and loss sharing
Hear an outline of the role of gain and loss sharing with whole population budgets, and an overview of a methodology for developing a gain and loss share. 

Capitated / whole population budgets: shadow-testing
Provides an outline of the context for payment development, an overview of shadow-testing approaches for new payment approach, and an opportunity to hear from a vanguard site that is making progress with shadow-testing a whole population budget.

Incentivising MCPs and PACS – the Health and Care Framework
Provides an outline of the context for incentivising quality and outcomes, an overview of the Health and Care Framework (HCF), and an opportunity to hear how the HCF is intended to operate including links with local commissioning priorities.


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    • nhsi
    • 24 Jan '17

    resource was opened for discussion.

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