Different payment approaches to support new care models

Support for local health and care economies to make the rapid shift to payment approaches that will underpin new care models.

The Five Year Forward View (5YFV) proposes a number of new models for providing NHS care that will break down barriers between GPs and hospitals, between physical and mental health and between health and social care, thereby helping promote person-centred and co-ordinated care for patients.

The efficiency of these new models is also expected to be crucial in closing the funding gap between available resources and patient needs that is projected without system change.

The examples below have been informed by the experiences of health and care economies in England and around the world and show how different payment approaches could help support the delivery of these new care models.

Background: reforming the NHS payment system

See how changes to the payment system will be critical for the adoption of the new models of care that does more for patients, and how the local payment examples may become payment approaches in the future.


An example of a potential new payment model to enable integrated care

  1. Capitation: an introduction

    • Guidance
  2. Local payment example: capitation

    • Guidance
  3. Capitation: international examples

    • Research and analysis

Multilateral gain/loss sharing

This local payment example enables finances to be reallocated across a local care economy when delivering new care models

Improving Access to Psychological Therapies payment

An approach to payment for providers of ‘Improving Access to Psychological Therapies’ (IAPT) services that links payment to patient outcomes as well as the provider’s levels of activity.

Outcomes-based payment for mental healthcare

A capitated approach to payment for mental health services with outcomes and risk share.

3-part payment for urgent and emergency care

A single, consistent payment approach that has the potential to drive greater collaboration between services within an urgent and emergency care network.

Published 16 July 2015
Last updated 12 August 2015 + show all updates
  1. New local payment example added for urgent and emergency care
  2. Local payment examples added for Improving Access to Psychological Therapies (IAPT) and outcomes-based payment for mental healthcare
  3. First published.