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Contents

  • Why commissioners are moving towards Outcomes Based Commissioning
  • What’s wrong with current, activity and process based commissioning
  • Examples of OBC currently underway
  • Peer reviewed case studies and related cases
  • OBC as a driver of provider collaboration, integration, innovation
  • Can we really afford not to?
  • What OBC is, what it means
  • How OBC fundamentally differs from existing approaches
  • The importance of sequence; defining population segments and outcomes before looking at contracts, IT payment system etc.
  • What it means for healthcare costs and outcomes – how would patients feel the difference in an outcomes based system?
  • Advantages of outcomes approaches – worked examples: e.g. not just purchasing a hip operation, instead paying for the extent and speed of return to physical activities and/or work- however achieved
  • Moving away from activity based commissioning categories (planned care, unscheduled care etc.) towards commissioning for pathways and populations of patients with similar needs
  • ‘How to’ segment commissioning according to similar needs
  • Dealing with co-morbidities, complex care needs, and segmentation complexities
  • Stopping patients ‘falling through the gaps’
  • Understanding some fundamentals – what’s an outcome, what’s not an outcome
  • Whose outcome is it anyway?
  • Strengths and weaknesses of structure, process and outcomes indicators
  • How PREMs and PROMs fit in
  • More challenging areas:
    • Defining outcomes frameworks for patient segments
    • Co-producing outcomes with patients
    • Understanding outcomes hierarchies
  • Innovative/emerging contracting models – to underpin moves towards OBC across multiple providers (e.g. Accountable Lead Provider, Alliance contracts, Federations/Networks)
  • Competition, procurement and tendering issues in commissioning services for outcomes
  • How to support competition over outcomes using different contractual models
  • Understanding the difference between price and cost, and why it’s important
  • How costing is done now, and how it needs to change
  • Latest developments in bundled pricing/reimbursement for OBC
  • Whole patient pathway payment examples (including international pilots)’
  • Payment across multiple providers
  • How enabling IT systems underpin development of outcomes based approaches
  • Data collection for outcomes-
  • Dealing with ‘messy data’
  • Dynamic PROMs and PREMs
  • What this means for patients and providers
  • Use of facilitated social networks to supporting outcomes based commissioning
  • How the provider market could evolve in response to the OBC stimulus with examples (e.g. Provider re-configuration – Integrated Practice Units now emerging: e.g. in Acute care – Department of joint pain, rather than current organizational divisions – Orthopaedics, Rheumatology etc.)
  • Ten things to do next if you want to commission for outcomes

The Outcomes Based Healthcare Book
Published on 07.08.2020