News / WPB handbook supports ACO development

Whole population models of provision: establishing integrated budgets is part of a suite of publications, some new and some updated, supporting the development of accountable care organisations (ACOs) and systems. 

Other documents look specifically at the incentive frameworks for ACOs and procurement issues.

The handbook has been in draft form for over a year and has been used by vanguard sites, and informed by their work, as they have set up new integrated models of service provision. 

Existing activity-based payment systems – for example, using national tariff prices – are seen as incentivising activity, while block contracts provide little incentive to deliver services not specified in the contract.

Under current payment approaches, a provider wanting to deliver services more proactively in the community and focus more on prevention to reduce hospital admissions might be financially disadvantaged. Whole population budgets are seen as a way of incentivising providers to optimise services across whole pathways, with providers given greater freedom in how services are delivered and commissioners holding them to account for outcomes. 

The handbook covers the key stages in developing WPBs, including using current spend on in-scope services to set the baseline budget. It also describes how improvement payment schemes can incentivise performance improvement across priority areas and covers gain/loss sharing mechanisms. 

See new payment model.