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Establishing a Fair Playing Field for Payment by Results

Author

Listed:
  • Anne Mason

    (Centre for Health Economics, University of York, UK.)

  • Marisa Miraldo

    (Centre for Health Economics, University of York, UK.)

  • Luigi Siciliani

    (Centre for Health Economics, University of York, UK.)

  • Peter Sivey

    (Centre for Health Economics, University of York, UK.)

  • Andrew Street

    (Centre for Health Economics, University of York, UK.)

Abstract

The English government has encouraged private providers – known as Independent Sector Treatment Centres (ISTCs) – to treat publicly funded (NHS) patients. Providers are paid a fixed price per patient treated, adjusted to reflect geographical differences in input costs. But there may be other legitimate cost variations between providers. This report considers the regulatory and production-process constraints that could cause public and private providers costs to differ. Most of these exogenous cost differentials can be rectified by adjustments to the regulatory system or to the payment method. We find evidence that ISTCs are treating different types of patients than NHS hospitals. If these differences drive costs, payments for treatment might need to be differentiated by setting.

Suggested Citation

  • Anne Mason & Marisa Miraldo & Luigi Siciliani & Peter Sivey & Andrew Street, 2008. "Establishing a Fair Playing Field for Payment by Results," Working Papers 039cherp, Centre for Health Economics, University of York.
    • Handle: RePEc:chy:respap:39cherp
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    File URL: http://www.york.ac.uk/media/che/documents/papers/researchpapers/rp39_payment_by_results.pdf
    File Function: First version, 2008
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    References listed on IDEAS

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    Cited by:

    1. Cooper, Zack & Gibbons, Stephen & Skellern, Matthew, 2018. "Does competition from private surgical centres improve public hospitals' performance? Evidence from the English National Health Service," Journal of Public Economics, Elsevier, vol. 166(C), pages 63-80.
    2. Moscelli, Giuseppe & Gravelle, Hugh & Siciliani, Luigi & Gutacker, Nils, 2018. "The effect of hospital ownership on quality of care: Evidence from England," Journal of Economic Behavior & Organization, Elsevier, vol. 153(C), pages 322-344.
    3. Klein-Hitpaß, Uwe & Scheller-Kreinsen, David, 2015. "Policy trends and reforms in the German DRG-based hospital payment system," Health Policy, Elsevier, vol. 119(3), pages 252-257.
    4. Galizzi, Matteo M. & Miraldo, Marisa, 2011. "The effects of hospitals' governance on optimal contracts: Bargaining vs. contracting," Journal of Health Economics, Elsevier, vol. 30(2), pages 408-424, March.
    5. Street, Andrew & Sivey, Peter & Mason, Anne & Miraldo, Marisa & Siciliani, Luigi, 2010. "Are English treatment centres treating less complex patients?," Health Policy, Elsevier, vol. 94(2), pages 150-157, February.
    6. Petrou, Panagiotis & Vandoros, Sotiris, 2018. "Healthcare reforms in Cyprus 2013–2017: Does the crisis mark the end of the healthcare sector as we know it?," Health Policy, Elsevier, vol. 122(2), pages 75-80.

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