What we hope to achieve
Since the NHS five year forward view, commissioners and service providers in different parts of England have been developing more integrated, place-based systems of care, first as part of the multispeciality community providers (MCP) and primary and acute care systems (PACS) vanguards, and more recently in the form of accountable care systems.
Some consensus is emerging on the shape of these systems, for example, the need to bring together budgets and services and to give providers greater responsibility for use of resources. However, there are strong differences of opinion on the appropriate financing arrangements for these new systems. Some commissioners are developing value-based payments similar to accountable care in the United States, while others are re-establishing block grants similar to health systems in New Zealand, parts of Sweden and Finland.
What we are doing
The King’s Fund is bringing together research on these different approaches to payments. The aim is to clarify the choices commissioners face in relation to payment systems and the arguments for and against different approaches, drawing lessons from recent experiences in contracting for integrated care in the UK and internationally.