Multilateral gain/loss sharing is a way of reallocating finances across a local care economy when delivering new care models
What is multilateral gain/loss sharing?
Multilateral gain/loss sharing involves multiple providers and one or more commissioners in a local care economy forming a network to identify and distribute financial gains and losses.
It works by comparing how much commissioners in the network were expected to spend delivering care with the actual amount they spent.
The difference between these two amounts forms the gains/losses pool. This pool is then distributed between all the commissioners and providers in that network.
For example, a reduction in non-elective admissions may lead to an overall reduction in spend across the board. This reduction would form a gains pool that could then be shared among the network, including the provider that has seen a reduction in its activity and the providers in the community that helped achieve this outcome.
Multilateral gain/loss sharing combined with an underlying payment model – such as capitation – defines the overall payment approach.
Help us refine and improve this approach
Some local health economies have already begun to explore how a multilateral gain/loss sharing mechanism can help support the integration of care and drive improved outcomes for patients. We’ll refine the payment example as we learn more from local health economies that implement these new models.
If you’re exploring the use of a multilateral gain/loss sharing mechanism, we’d like to hear about your experiences. Email us at firstname.lastname@example.org
Multilateral gain/loss sharing in detail
- Our paper, Multilateral gain/loss sharing: a financial mechanism to support collaborative service reform, provides examples for finance, contracting and commissioning staff of how to develop and implement such financial mechanisms locally.
- Multilateral gain/loss sharing: an introduction is for chief executives, clinicians and others who require a broad understanding of Monitor and NHS England’s proposed new payment approach to support the service reform, but who do not need detailed guidance on payment design and implementation.