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Contracting & reimbursement

Overview

Overview

Many health care reforms have addressed alternative designs for the mechanisms through which commissioning of health services is organised and paid for. Our contribution to this broad area of research include:

  • how to achieve integration of funding across health and social care settings
  • work to support budget setting and contracting arrangements for commissioning bodies
  • how to predict costs of care in different health and social care settings
  • design and evaluation of casemix classification systems such as DRGs and HRGs
  • design and refinement of reimbursement arrangements for mental health services, primary care and hospital care
  • evaluation of performance and quality under different incentive arrangements, including pay-for performance

Contact: Anne Mason

Publications

Publications

2021

  • Bodnar O, Gravelle H, Gutacker N, Herr A. Financial incentives and prescribing behaviour in primary care. Centre for Health Economics, University of York; CHE Research Paper 181 (PDF , 1,233kb) 2021.

2020

  • Corbacho Martín B, Drummond M, Santos R, Jones E et al. Does the use of health technology assessment have an impact on the utilisation of health care resources? Evidence from two European countries. The European Journal of Health Economics 2020;21(4):621-634. Download from Springer
  • de Oliveira C, Cheng J, Chan K, Earle CC, Krahn M, Mittmann N. High-cost patients and preventable spending: A population-based study. JNCCN Journal of the National Comprehensive Cancer Network 2020;18(1):23-31. Download from JNCCN
  • Gravelle H, Schroyen F. Optimal hospital payment rules under rationing by waiting. Journal of Health Economics 2020;70:102277. Download from Science Direct
  • Rodriguez Santana I, Anaya Montes M, Chalkley M, Jacobs R, Kowalski T, Suter J. The impact of extending nurse working hours on staff sickness absence: Evidence from a large mental health hospital in England. International Journal of Nursing Studies 2020;112:103611. Download from Elsevier
  • Suter J, Kowalski T, Anaya Montes M, Chalkley M, Jacobs R, Rodriguez Santana I. The impact of moving to a 12 hour shift pattern on employee wellbeing: a qualitative study in an acute mental health setting. International Journal of Nursing Studies 2020;112:103699. Download from Elsevier

2019

  • Feng Y, Gravelle H. Details matter: Physician responses to multiple payments for the same activity. Social Science and Medicine 2019;234:112343. Download from Elsevier
  • Gaughan J, Gutacker N, Grasic K, Kreif N, Siciliani L, Street A. Paying for efficiency: Incentivising same-day discharge in the English NHS. Journal of Health Economics2019; 68:102226. Download from Elsevier
  • Kasteridis P, Liu D, Mason A, Goddard M, Jacobs R, Wittenberg R, Howdon D. The impact of primary care incentive schemes on care home placements for people with dementia. Centre for Health Economics, University of York;CHE Research Paper 164 (PDF , 2,366kb)
  • L’Esperance V, Gravelle H, Schofield P, Santos R, Ashworth M. Relationship between general practice capitation funding and the quality of primary care in England: a cross-sectional, 3-year study. BMJ Open2019;9(11);e030624. Download from BMJ
  • Liu D, Green E, Kasteridis P, Goddard M, Jacobs R, Wittenberg R, Mason A. Incentive schemes to increase dementia diagnoses in primary care in England: a retrospective cohort study of unintended consequences. British Journal of General Practice 2019;69(680):e154-e163. Download from BJGP 
  • Longo F, Siciliani L, Street AD. Are costs differences between specialist and general hospitals compensated by the prospective payment system? European Journal of Health Economics 2019;20(1):7-26. Download from Springer 

2018

  • Chalkley MJ. Incentives and performance of health care professionals. Oxford Research Encyclopedia of Economics and Finance Aug 2018;doi:10.1093/acrefore/9780190625979.013.264. Download from Oxfordre.com 
  • Chalkley M, Listl S. First do no harm – The impact of financial incentives on dental x-rays. Journal of Health Economics 2018;58:1-9. Download from Elsevier 
  • Gaughan J, Gutacker N, Grasic K, Kreif N, Siciliani L, Street A. Paying for efficiency: Incentivising same-day discharges in the English NHS. Centre for Health Economics, University of York; CHE Research Paper 157 (PDF , 2,139kb)2018. 
  • Gutacker N, Bloor KE, Bojke C, Walshe K. Should interventions to reduce variation in care quality target doctors or hospitals? Health Policy 2018;122(6):660-666. Download from ScienceDirect 
  • Mason A, Liu D, Kasteridis P, Goddard M, Jacobs R, Wittenberg R, McGonigal G. Investigating the impact of primary care payments on underdiagnosis in dementia: A difference-in-differences analysis. International Journal of Geriatric Psychiatry 2018;33(8):1090-1097. Download from Wiley 
  • Yong J, Scott A, Gravelle H, Sivey P, McGrail M. Do rural incentives payments affect entries and exits of general practitioners? Social Science and Medicine 2018;214:197-205. Download from Sciencedirect

2017

  • Aragón MJ, Chalkley M, Goddard M. Defining and measuring unmet need to guide healthcare funding: identifying and filling the gaps. Centre for Health Economics, University of York; CHE Research Paper 141 (PDF , 1,502kb) 2017.
  • Bojke C, Grasic K, Street A. How should hospital reimbursement be refined to support concentration of complex care services? Health Economics 2017;doi:10.1002/hec.3525. Download from Wiley
  • Chalkley M, Listl S. First do no harm – The impact of financial incentives on dental x-rays. Centre for Health Economics, University of York; CHE Research Paper 143 (PDF , 1,152kb) 2017.‌
  • Goddard M, Mason A. Integrated  care: A pill for all ills? International Journal of Health Policy and Management 2017;6(1):1-3. Download from IJHPM
  • Jehu L, Visram S, Marks L, Hunter D, Davis H, Mason A, Liu D, Smithson J. Directors of public health as “a protected species”: qualitative study of the changing role of public health professionals in England following the 2013 reforms. Journal of Public Health 2017;doi:10.1093/ pubmed/fdx154. Download from OUP
  • Longo F, Siciliani L, Street AD. Are costs differences between specialist and general hospitals compensated by the prospective payment system? European Journal of Health Economics 2017;doi:10.1007/s10198-017-0935-1 Oct 26. Download from Springer

2016

  • Asaria M, Grasic K, Walker S. Using linked electronic health records to estimate healthcare costs: key challenges and opportunities. PharmacoEconomics 2016;34(2):155-160.
  • Davis H, Marks L, Jehu L, Virsram S, Hunter DJ, Liu D, Mason A, Melvin K, Smithson J. Commissioning public health services: the impact of the health reforms on access, health inequalities and innovation in service provision: An innovation framework for public health commissioning. Durham University2016 Report 6 Sept;pp1-90. 
  • Fischera E, Gravelle H, Pezzino M, Sutton M. Quality target negotiation in health care: evidence from the English NHS. European Journal of Health Economics 2016;17(7):811-822.
  • Gravelle H, Schroyen F. Optimal hospital payment rules under rationing by random waiting. Centre for Health Economics, University of York; CHE Research Paper 130 (PDF , 2,013kb) 2016.
  • Marks L, Jehu L, Visram S, Melvin K, Davis H, Hunter D, Liu D, Mason A, Smithson J. Commissioning public health services: the impact of the health reforms on access, health inequalities and innovation in service provision: Results from first phase fieldwork in ten case study sites across England. Durham University 2016 Report 5 October;pp1-107. 
  • Marks L, Mason A, Liu D, Taylor C, Virsram S, Davis H, Hunter D, Smithson J. Commissioning public health services: the impact of the health reforms on access, health inequalities and innovation in service provision: Results of a national survey of Directors of Public Health and Clinical Commissioning Group members of Health and Wellbeing Boards. Durham University 2016 report 4 Jun;pp1-55
  • Marks L, Visram S, Brown S, Davis H, Hunter DJ, Liu D, Mason A, Smithson J, Taylor C. Commissioning public health services: the impact of the health reforms on access, health inequalities and innovation in service provision: Views of national stakeholders. Durham University 2016 Feb; p;1-36.
  • Mason A, Liu D, Marks L, Davis H, Hunter DJ, Smithson J, Taylor C, Visram S. Commissioning public health services: the impact of the health reforms on access, health inequalities and innovation in service provision: The Public Health Budget. Durham University 2016 Feb; p:1-95.
  • Russell H, Street A, Ho V. How well do all patient refined–diagnosis-related groups explain costs of pediatric cancer chemotherapy admissions in the United States? Journal of Oncology Practice 2016;doi:10.1200/JOP.2015.010330. 
  • Taylor C, Marks L, Smithson J, Davis H, Hunter DJ, Liu D, Mason A, Visram S. Commissioning public health services: the impact of the health reforms on access, health inequalities and innovation in service provision: National surveys. Durham University 2016 report 3 Jun;pp1-55.

2015

  • Bojke C, Grasic K, Street A. How much should be paid for Prescribed Specialised Services? Centre for Health Economics, University of York; CHE Research Paper 118 (PDF , 2,238kb) 2015. Lay Summary 118 (PDF , 275kb) PSS 3 yr All regressions (MS Excel , 130kb)
  • Grašič K, Mason AR, Street A. Paying for the quantity and quality of hospital care: the foundations and evolution of payment policy in England. Health Economics Review 2015;5(15).
  • Gutacker N, Street A, Gomes C, Bojke C. Should English healthcare providers be penalised for failing to collect patient-reported outcome measures (PROMs)? A retrospective analysis of linked routine administrative data. Journal of the Royal Society of Medicine 2015;doi:10.1177/0141076815576700. Download from sagepub
  • Kasteridis P, Street A, Dolman M, Gallier L, Hudson K, Martin J, Wyer I. Who would benefit most for improved integrated care? Implementing an analytical strategy in South Somerset. International Journal of Integrated Care 2015;15:Jan-Mar:1-11. Download from ijic
  • Mason A, Goddard M, Weatherly H, Chalkley M. Integrating funds for health and social care: an evidence review (PDF  , 215kb). Journal of Health Services Research & Policy 2015;doi:10.1177/1355819614566832. 

2014

  • Bardsley M, Street A. Cost of integrated care. In: Curtis L. (ed). Unit Costs of Health & Social Care 2014. PSSRU University of Kent, Canterbury;2014:pp13-18. Download from PSSRU
  • Bojke C, Grašič K, Street A. The costs of specialised care. Centre for Health Economics, University of York; CHE Research Paper 103 (PDF  , 1,811kb), 2014. Accompanying spreadsheet CHERP103 descriptive statisitcs (MS Excel  , 1,556kb)
  • Brilleman SL, Gravelle H, Hollinghurst S, Purdy S, Salisbury C, Windmeijer F.  Keep it simple? Predicting primary health care costs with clinical morbidity measures. Journal of Health Economics 2014;35:109-122.
  • Harrison M, Dusheiko M, Sutton M, Gravelle H, Doran T, Roland M. Effect of a national primary care pay for performance scheme on emergency hospital admissions for ambulatory care sensitive conditions: controlled longitudinal study. BMJ 2014;349:g6423.
  • Kasteridis P, Street A, Dolman M, Gallier L, Hudson K, Martin J, Wyer I. The importance of multimorbidity in explaining utilisation and costs across health and social care settings: evidence from South Somerset’s Symphony Project. Centre for Health Economics, University of York; CHE Research Paper 96 (PDF  , 2,352kb) 2014. Health Service Journal 10 April 2014 and data video.
  • Jacobs R. Payment by results for mental health services: economic considerations of case-mix funding. Advances in Psychiatric Treatment 2014;20:155-164.
  • Kronenberg C, Barros PP. Catastrophic healthcare expenditure–drivers and protection: The Portuguese case. Health Policy 2014;115(1):44-51. Download from elsevier
  • Listl S, Chalkley M. Provider payment bares teeth: Dentist reimbursement and the use of check-up examinations. Social Science & Medicine 2014;111:110-116.
  • Mason A, Goddard M, Weatherly H. Financial mechanisms for integrating funds for health and social care: an evidence review. Centre for Health Economics, University of York; CHE Research Paper 97 (PDF  , 1,259kb), 2014.
  • Mason A, Goddard M, Weatherly H. Financial mechanisms for integrating funds for health and social care: do they enable integrated care? International Journal of Integrated Care2014;14(6);Annual Conference Supplement;URN:NBN:NL:UI:10-1-116181.
  • Martin S, Street A, Han L, Hutton J. The impact of hospital financing on the quality of inpatient care in England. Centre for Health Economics, University of York; CHE Research Paper 105 (PDF  , 1,930kb), 2014.

2013 

  • Brilleman SL, Purdy S, Salisbury C, Windmeijer F, Gravelle H, Hollinghurst S. Implications of comorbidity for primary care costs in the UK: a retrospective observational study. British Journal of General Practice 2013;63(609):e274-e82.
  • Busse R, Geissler A, Aaviksoo A, Cots F, Häkkinen U, Kobel C, Mateus C, Or Z, O’Reilly J, Serdén L, Street A, Swan Tan S, Quentin W. Diagnosis related groups in Europe: moving towards transparency, efficiency, and quality in hospitals? British Medical Journal 2013;346(F3197). Download from BMJ
  • Daidone S, Street AD. How much should be paid for specialised treatment? Social Science and Medicine 2013;84:110-8. Download from Sciencedirect
  • Fichera E, Gravelle H, Pezzino M, Sutton M. Choice of contracts for quality in health care: Evidence from the British NHS. Centre for Health Economics, University of York; CHE Research Paper 85 (PDF , 968kb) 2013.
  • Gravelle H, Scott A, Sivey P, Yong J. Competition, prices, and quality in the market for physician consultations. Centre for Health Economics, University of York; CHE Research Paper 89 (PDF , 566kb) 2013.
  • Marks L, Weatherly HLA, Mason A. Prioritizing investment in public health and health equity: what can commissioners do? Public Health 2013;127(5):410-418.

2012 

  • Daidone S, Street A. Specialisation hierarchy within the Children’s Specialised Services National Definition Set. Report to Department of Health, Economics of Social and Health Care Research Unit, University of York; 2012. Download from eshcru
  • Gravelle H, Santos R, Siciliani L, Goudie R. Hospital quality competition under fixed prices: Centre for Health Economics, University of York; CHE Research Paper 80 (PDF , 1,256kb) 2012. Lay Summary 80 (PDF  , 310kb)
  • Kontopantelis E, Doran T, Gravelle H, Siciliani L, Sutton M, Goudie R. Pay-for-performance and influenza immunization: the impact of raising the bar in the UK Quality and Outcomes Framework. Health Services Research 2012;47(3, part 1):1117-36.
  • Mason A, Or Z, Renaud T, Street A, Thuilliez J, Ward P. How well do DRGs for appendectomy explain variations in resource use? An analysis of patient-level data from 10 European countries. Health Economics 2012;21(S2):30-40. Download from wiley
  • Miraldo M, Siciliani L, Street A. Price adjustment in the hospital sector, Reply. Journal of Health Economics 2012;31(1):323-25.
  • O'Reilly J, Busse R, Häkkinen U, Or Z, Street A, Wiley M. Paying for hospital care: the experience with implementing activity-based funding in five European countries. Health Economics Policy and Law 2012;7(1):73-101.
  • Street A, Kobel C, Renaud T, Thuilliez J. How well do Diagnosis Related Groups explain variations in costs or length of stay among patients and across hospitals? Methods for analysing routine patient data. Health Economics 2012;S21:6-18. Download from wiley

 2011

  • Daidone S, Street A. Estimating the costs of specialised care: updated analysis using data for 2009/10. Centre for Health Economics, University of York; CHE Research Paper 71 (PDF  , 325kb)‎ 2011.
  • Daidone S, Street A. Estimating the costs of specialised care. Centre for Health Economics, University of York; CHE Research Paper 61 (PDF  , 342kb)‎ 2011.
  • Dixon J, Smith PC, Gravelle H, Martin S, Bardsley M, Rice N, Georghiou T, Dusheiko M, Billings J, De Lorenzo M, Sanderson C. A person based formula for allocating commissioning funds to general practices in England: development of a statistical model. British Medical Journal 2011;DOI: 10.1136/bmj.d6608.
  • Gravelle H, Dusheiko M, Martin S, Smith P, Rice N, Dixon J. Modelling individual patient hospital expenditure for general practice budgets. Centre for Health Economics, University of York; CHE Research Paper 73 (PDF  , 358kb)‎ 2011.
  • Gravelle H, Hole AR, Santos R. Measuring and testing for gender discrimination in physician pay: English family doctors. Journal of Health Economics 2011;30(4):660-74.
  • Marks L, Cave S, Wallace A, Mason A, Hunter DJ, Mason JM, Peckham S. Incentivising preventive services in primary care: perspectives on the use of Local Enhanced Services. Journal of Public Health 2011.
  • Mason A, Goddard M, Myers L, Verzulli R. Navigating uncharted waters? How international experience can inform the funding of mental health care in England. Journal of Mental Health 2011;20(3);234-48. Download from informa.
  • Mason A, Ward P, Street A. England: the Healthcare Resource Group system. In: Busse R, Geissler A, Quentin W, Wiley M, editors. Diagnosis related groups in Europe: moving towards transparency, efficiency and quality in hospitals. Berkshire, England: Open University Press;2011;p197-220.
  • Maynard A, Street A, Hunter R. Using ‘payment by results’ to fund the treatment of dependent drug users-proceed with care! Addiction 2011;106(10):1715-1882.
  • Morris S, Goudie R, Sutton M, Gravelle H, Elliott R, Hole A, Ma A, Sibbald B, Skatun D. Determinants of general practitioners’ wages in England. Health Economics 2011;20:147-60.
  • Street A, O'Reilly J, Ward P, Mason A. DRG-based hospital payment and efficiency: theory, evidence, and challenges. In: Busse R, Geissler A, Quentin W, Wiley M, editors. Diagnosis Related Groups in Europe: moving towards transparency, efficiency and quality in hospitals. Berkshire, England:Open University Press;2011:p93-114.