Payment reform, purchaser and provider decisions and the performance of emergency healthcare systems: The case of blended payment in the English NHS

Martin John Chalkley; Hugh Stanley Emrys Gravelle; Nikita Jacob; Rita Santos; Luigi Siciliani

Payment reform, purchaser and provider decisions and the performance of emergency healthcare systems: The case of blended payment in the English NHS

Martin John Chalkley, Hugh Stanley Emrys Gravelle, Nikita Jacob, Rita Santos, Luigi Siciliani

Research output: Working paper › Discussion paper

Abstract

This paper constitutes the first and foundational output of the ESHCRU2 project 3 - Analysis of purcher-provider contracts: modelling risk sharing and incentive implications. In this project, we have focused on the implications of payment reform of what is called blended payment for emergency care. This paper sets out the theoretical model developed to understand how behavioural choices could be influenced by this payment reform. We construct a framework in which two organisations - a hospital and a purchaser - influence respectively admissions from, and attendance at, emergency departments. These decisions are each influenced by the payment system and interact to determine an equilibrium. We show how the equilibrium is affected by the characteristics of the hospital and the purchaser and how it will be changed by shifting towards a greater reliance on fixed payment. We further establish what outcomes (in terms of admissions and attendances) can be sustained as an equilibrium under different parameters of the payment system.

Original language	English
Place of Publication	York, UK
Publisher	Centre for Health Economics, University of York
Number of pages	33
Publication status	Published - 17 Aug 2022

Publication series

Name	CHE Research Paper
Publisher	Centre for Health Economics, University of York
No.	187

Access to Document

CHERP187_payment_reform_healthcare_systemsFinal published version, 1.84 MB

https://www.york.ac.uk/media/che/documents/papers/researchpapers/CHERP187_payment_reform_healthcare_systems.pdf

Cite this

Chalkley, M. J., Gravelle, H. S. E., Jacob, N., Santos, R., & Siciliani, L. (2022). Payment reform, purchaser and provider decisions and the performance of emergency healthcare systems: The case of blended payment in the English NHS . (CHE Research Paper; No. 187). Centre for Health Economics, University of York. https://www.york.ac.uk/media/che/documents/papers/researchpapers/CHERP187_payment_reform_healthcare_systems.pdf

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abstract = "This paper constitutes the first and foundational output of the ESHCRU2 project 3 - Analysis of purcher-provider contracts: modelling risk sharing and incentive implications. In this project, we have focused on the implications of payment reform of what is called blended payment for emergency care. This paper sets out the theoretical model developed to understand how behavioural choices could be influenced by this payment reform. We construct a framework in which two organisations - a hospital and a purchaser - influence respectively admissions from, and attendance at, emergency departments. These decisions are each influenced by the payment system and interact to determine an equilibrium. We show how the equilibrium is affected by the characteristics of the hospital and the purchaser and how it will be changed by shifting towards a greater reliance on fixed payment. We further establish what outcomes (in terms of admissions and attendances) can be sustained as an equilibrium under different parameters of the payment system. ",

author = "Chalkley, {Martin John} and Gravelle, {Hugh Stanley Emrys} and Nikita Jacob and Rita Santos and Luigi Siciliani",

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day = "17",

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Chalkley, MJ , Gravelle, HSE , Jacob, N , Santos, R & Siciliani, L 2022 'Payment reform, purchaser and provider decisions and the performance of emergency healthcare systems: The case of blended payment in the English NHS ' CHE Research Paper, no. 187, Centre for Health Economics, University of York, York, UK. <https://www.york.ac.uk/media/che/documents/papers/researchpapers/CHERP187_payment_reform_healthcare_systems.pdf>

Payment reform, purchaser and provider decisions and the performance of emergency healthcare systems: The case of blended payment in the English NHS . / Chalkley, Martin John ; Gravelle, Hugh Stanley Emrys ; Jacob, Nikita et al.
York, UK: Centre for Health Economics, University of York, 2022. (CHE Research Paper; No. 187).

Research output: Working paper › Discussion paper

TY - UNPB

T1 - Payment reform, purchaser and provider decisions and the performance of emergency healthcare systems

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AU - Chalkley, Martin John

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AU - Jacob, Nikita

AU - Santos, Rita

AU - Siciliani, Luigi

PY - 2022/8/17

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AB - This paper constitutes the first and foundational output of the ESHCRU2 project 3 - Analysis of purcher-provider contracts: modelling risk sharing and incentive implications. In this project, we have focused on the implications of payment reform of what is called blended payment for emergency care. This paper sets out the theoretical model developed to understand how behavioural choices could be influenced by this payment reform. We construct a framework in which two organisations - a hospital and a purchaser - influence respectively admissions from, and attendance at, emergency departments. These decisions are each influenced by the payment system and interact to determine an equilibrium. We show how the equilibrium is affected by the characteristics of the hospital and the purchaser and how it will be changed by shifting towards a greater reliance on fixed payment. We further establish what outcomes (in terms of admissions and attendances) can be sustained as an equilibrium under different parameters of the payment system.

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BT - Payment reform, purchaser and provider decisions and the performance of emergency healthcare systems

PB - Centre for Health Economics, University of York

CY - York, UK

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