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This article examines the incidence and determinants of payment‐by‐results systems in Britain. Data at the establishment level are used to estimate a probit model which…
This article examines the incidence and determinants of payment‐by‐results systems in Britain. Data at the establishment level are used to estimate a probit model which identifies those structural characteristics that impact on the choice of payment system for manual workers.
In December 2010, the Ministry of Justice published its criminal justice reform green paper, Breaking the Cycle: Effective punishment, rehabilitation and sentencing of…
In December 2010, the Ministry of Justice published its criminal justice reform green paper, Breaking the Cycle: Effective punishment, rehabilitation and sentencing of offenders, which sets out the government's ambition for all criminal justice services to be delivered according to payment by results principles by 2015. This article describes the proposals contained in the green paper to implement a process of payment by results across the criminal justice system, examines some existing examples of payment by results‐based projects, and discusses some of the key questions that need to be resolved in the development of this new approach.
Discusses the long existing and confusing problems of establishing the relationship of who is, and who if not, a dependent worker. Reflects developments which have…
Discusses the long existing and confusing problems of establishing the relationship of who is, and who if not, a dependent worker. Reflects developments which have occurred in British law as it affects the employment field, plus an evaluation and analysis of some of the different types of employment relationships which have evolved by examining, where possible, the status of each of these relationships. Concludes that the typical worker nowadays finds himself in a vulnerable position both economically and psychologically owing to the insecurity which exists.
The Treasury, in exercise of the powers conferred on them by section 2 of the Counter‐Inflation Act 1973 and of all other powers enabling them in that behalf, and having…
The Treasury, in exercise of the powers conferred on them by section 2 of the Counter‐Inflation Act 1973 and of all other powers enabling them in that behalf, and having consulted the Price Commission and the Pay Board and representatives of consumers, persons experienced in the supply of goods or services, employers and employees and other persons in accordance with subsection (4) of the said section 2, hereby make the following Order:—
ENGINEERING'S chief contribution to National Productivity Year has been the joint conference arranged by the Institutions of Mechanical Engineers and Production Engineers. Although the theme was ‘Productivity and the Engineer’, Lord Hailsham, Minister for Science, scanned a wider horizon in his opening address.
DESPITE assurances from the Union most concerned that “every endeavour will be made to keep Montague Burton workers in employment” it seems inevitable that the massive redundancies announced a month ago will take place. Nor does it seems possible that these unfortunate people will readily find employment elsewhere — certainly not in the towns where they are living and working now. In every sense, it will mean a major upheaval for most of them.
Three types of payment methods have been introduced across European countries in attempts to encourage better, more integrated care of persons with multimorbidity…
Three types of payment methods have been introduced across European countries in attempts to encourage better, more integrated care of persons with multimorbidity: pay-for-performance; pay-for-coordination; and an all-inclusive payment method. We examine whether there are differences in the way these payment methods affect health and healthcare use in persons with multimorbidity.
Using individual-level survey data from twenty European countries, we examine unadjusted differences in average outcomes for the years 2011–2015 by whether countries adopted new payment methods for integrated care. We then test for a differential effect for multimorbid persons using linear, individual random effects regressions, including country and time fixed effects and clustering standard errors at the country level.
We find little effect of varying payment methods on key outcomes for multimorbid individuals despite the theoretical predictions and the rhetoric in many policy documents.
Policymakers should bear in mind that the success of the payment method relies on the specific design of the incentives and their implementation. New effective models of care and how to incentivise these for multimorbid patients is an ongoing research priority.
This paper is the first to study the effects of payments for integration on the dimensions and populations these schemes intend to affect; health and healthcare use at the individual level for multimorbid individuals.
Coding clinical work should allow accurate and precise methods of assessing individual or department activity. The NHS financial reforms have increased correct diagnostic…
Coding clinical work should allow accurate and precise methods of assessing individual or department activity. The NHS financial reforms have increased correct diagnostic coding importance by introducing “payment by results” so that funding is directly linked to patient activity. The aim of this study is to assess the accuracy of procedure codes (OPCS 4.4), and its effect on Healthcare Resource Group tariff codes that directly affect revenue.
A total of ten procedures from ten consultants were randomly selected over one month. Each consultant coded his or her own procedures. From these codes, Healthcare Resource Group tariff codes were assigned to each patient. These were compared with procedure and Healthcare Resource Group tariff codes generated by coding department staff.
Of 100 procedures, four were un‐coded by coding department staff. There was concordance in 35 per cent of cases. Coders only gave one code for each procedure, whereas 35 per cent of procedures coded by consultants were assigned multiple codes. This resulted in 27 per cent of cases generating a different Healthcare Resource Group tariff code. Of the cases, five resulted in a difference of £4,000 or more; however, the overall difference was a £3,367 revenue loss if coder's codes were used.
Study numbers were limited to 100 with five cases showing excessive financial gain or loss significantly influencing the overall result.
Present procedure coding practice is inaccurate and results in Healthcare Resource Group tariff codes that do not accurately represent clinical activity and productivity. Under payment by results, this can result in a significant revenue loss and possibly ultimately future referrals. Therefore, coding practice needs to be improved as a matter of urgency. Arguably, this could be achieved by closer communication between coders and clinicians.
The paper identifies a flaw in the way clinical activity and productivity is assessed at present. This is fundamental to the process on which “payment by results” is based, and therefore must be addressed if trusts are to be financially successful.
PROGRAMME Evaluation and Review Technique, familiarly known as PERT, is a vital subject which is growing rapidly. Recognition of this drew an interested audience to a symposium at Keele University on July 13, when 14 companies contributed papers on different aspects of critical path‐planning techniques and their experience as users in such disparate fields as shipbuilding, aviation, nuclear and civil engineering, the chemical and electrical industries, and management consultancy.
This paper reports on the results of a two‐year study of the effects of newly introduced incentive payment systems (funded by the Department of Employment and the Social…
This paper reports on the results of a two‐year study of the effects of newly introduced incentive payment systems (funded by the Department of Employment and the Social Science Research Council). At the time the study began many organisations in Britain were considering introducing self financing productivity schemes which involved changes to their wage payment systems. This provided the project team with a unique opportunity for a large‐scale comparative study of the effects of introducing new reward schemes designed to encourage better performance at work, supplemented by in‐depth studies of a smaller number of organisations.