Contracting models Key benefits Key risks System and relationships Unable to support transformational already in place change As-is (Do No costs (HR/VAT) Inability to move funding around the nothing option) associated with system implementation Current system and Ability to share profits may be limited relationships could be based on need to make savings up’ to implement within QIPP and may encourage ‘geared Informal this model relatively easily adverse competition network No costs (HR/VAT) Arrangements are non-statutory and approach with associated with potentially unsustainable, e.g. profit / risk implementation uncertain governance arrangements sharing for dealing with any deficits Complex contracting processes with multiple organisations All providers brought May be difficult for providers to show together contractually within evidence of achievement of balanced a single ACO scorecard objectives are focused around the Works best where providers are achievement of an agreed given a pooled budget for integrated Accountable set of balanced scorecard care Care objectives Need to move towards payments Organisation No (HR/VAT) based on risk/ outcomes rather than (ACO) associated with fee-for-service (PBR) implementation Evidence from the suggests model can improve quality of care and lower costs A single provider takes all Ability to identify/ agree an existing or responsibility for providing new local provider who can take on care within a pathway, this accountability Integrated therefore contracting is Requires true integration across Care Hubs straightforward providers, e.g. information sharing (Prime No organisational change and culture change (staff to think of Provider required, assuming an themselves as a unified organisation) model) existing provider becomes May be costs (HR/VAT) associated the prime provider with implementation if any staff move across to the prime provider
Contracting models Key benefits Key risks As-is (Do nothing option) System and relationships already in place No costs (HR/VAT) associated with implementation Unable to support transformational change Inability to move funding around the system Informal network approach with profit / risk sharing Current system and relationships could be ‘geared up’ to implement this model relatively easily No costs (HR/VAT) associated with implementation Ability to share profits may be limited based on need to make savings within QIPP and may encourage adverse competition Arrangements are non-statutory and potentially unsustainable, e.g. uncertain governance arrangements for dealing with any deficits Complex contracting processes with multiple organisations Accountable Care Organisation (ACO) All providers brought together contractually within a single ACO are focused around the achievement of an agreed set of balanced scorecard objectives No (HR/VAT) associated with implementation Evidence from the suggests model can improve quality of care and lower costs May be difficult for providers to show evidence of achievement of balanced scorecard objectives Works best where providers are given a pooled budget for integrated care Need to move towards payments based on risk/ outcomes rather than fee-for-service (PBR) Integrated Care Hubs (Prime Provider model) A single provider takes all responsibility for providing care within a pathway, therefore contracting is straightforward No organisational change required, assuming an existing provider becomes the prime provider Ability to identify/ agree an existing or new local provider who can take on this accountability Requires true integration across providers, e.g. information sharing and culture change (staff to think of themselves as a unified organisation) May be costs (HR/VAT) associated with implementation if any staff move across to the prime provider