Projects

Co-design of outcome-focused performance-based contracts in primary health care

Client.
Hunter New England Central Coast Primary Health Network
Services
Design, Engagement

Using rapid prototyping and testing to co-design evidence-based measures supporting collaboration and performance for patient outcomes.

01.
Client issue

Primary Health Networks are responsible for understanding the needs of their catchment and designing and commissioning services to meet those needs. Our client, Hunter New England Central Coast Primary Health Network (HNECCPHN), is committed to innovation and genuine partnership as a framework for the services they commission.

HNECCPHN focused on two programs delivered through a range of external providers as the first step to designing and implementing new performance-based contracts that connected back to outcomes for patients.

02.
Our approach

We worked with the client and two large providers to do a ground-up design and ‘learning-by-doing’ test of a new approach, one which recognised and responded to the aims of all participants. Drawing on existing Patient Reported Measures, we collectively designed four tests, covering two programs and four different tools, in a process that took less than 5 months from start to finish. These tests established the outcomes measurement approach.

Alongside the test we provided strategic advice for contract design and implementation, identifying the major levers and options for settings. This included methods to enhance collaboration and provide for flexibility in response to changed environments.

03.
Result

Participants commented on the extent to which this approach not just delivered a workable approach, but also built real trust and created a foundation for future joint work.

HNECC PHM has changed their contracting structure and plans to use this approach as a basis for future similar contracts.

04.
Key learnings

  • There is powerful wisdom in groups identifying their mutual objectives and working to achieve as many of those as possible.
  • Standardised tested tools are robust, but may also introduce challenges that impede the ability to achieve outcomes for patients, particularly for First Nations people.
  • Aligning incentives for performance is easier in a trusted and collaborative environment.

“Maura and Greg take the time to listen to our issues, process large amounts of background information, ask us the challenging questions to help us think differently and then work with us on implementing realistic solutions. Bringing experience from other industries and applying it to complex problems in a health setting has accelerated the implementation of our project.”

Executive Manager