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)