Monitor is to begin ‘co-designing’ and testing models for capitation based payment systems to help in the commissioning of new models for integrated care.
The regulator’s pricing development lead, Jyrki Kolsi, has said the next two years will be a testing period to help it design the best examples of capitated payments for patient care.
Capitation, in which a provider or group of providers is given a budget to look after the care of a particular population such as patients with long term conditions, was endorsed in the NHS Five Year Forward View.
A Monitor spokesman added that “vanguard” sites for new care models – such as multispecialty community provider and primary and acute care systems – which looked at adopting capitated payment systems would benefit from tailored support.
Speaking last week, Mr Kolsi said: “Going forward, we are planning to work more closely with sites to co-design capitation and test capitation.
“We are very clear that we need to quite carefully test alternative capitation designs before we can go out and say ‘these are the right things to do’.
“We’re not there yet and we see 2015-16 and 2016-17 being a testing and piloting period locally. We can then draw national conclusions on what are the right choices going through the design features list.
Addressing a conference on new models of commissioning for integrated care, organised by the social enterprise Primary Care Commissioning, Mr Kolsi emphasised that organisations would be free to design payments system locally.
Mr Kolsi said: “Monitor will not dictate how local areas deliver integrated care.
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“There is no one right model, there are lots of models. Obviously, those [described in] the NHS Five Year Forward View are about what types of organisations might do it in terms of care models.”
Mr Kolsi added that Monitor plans to publish a “how to guide” to help local NHS bodies better link up payment and costing data, which he described as an essential part of moving towards integrating care.
The guide will build on research Monitor published in November citing examples of local capitated payment systems and is planned for publication around April.
A Monitor spokesman said: “For the past 6-12 months we have been working with a number of local areas on different aspects of payment design, largely drawn from the first and second wave integrated care pioneers.
“We are not imposing a limit on the number of local areas that we work with, but instead the number of sites is determined by the number of areas who express interest and have the pre-conditions in place.
“These pre-conditions include a shared vision for their care model, established governance for whole system decision making and plans to bring together the necessary data (from across providers) to do the analysis. A large number of the vanguard applications for MCPs and PACS have asked for support on payment design and modelling.”
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