Key Components of the Payment by Results System

Executive Summary

The Payment by Results (National Tariff) system runs on patient-level data. In order to work, three key components. These are:

  • Classification system – required to capture information about patient diagnoses and healthcare interventions in a standard format (ICD-10 and OPCS-4, combining into HRG4+ codes)
  • Classification systems are grouped into currencies, the unit of healthcare for which payment is made (currencies)
  • Costing information – assigning costs to currencies, which in most cases is done nationally (the National Tariff itself)