Financial modelling showing the relationship between modelled changes in practice funding and secondary care costsa
| Practice funding type | Outcome significantly associated with capitation funding | Cost of notional increase in capitation funding, per 1000 registered patients | Modelled savings in secondary care costs associated with notional increase in capitation funding | Modelled secondary care savings: savings as a % of notional investment in primary careb |
|---|---|---|---|---|
| GMS practices, no MPIG | Outpatient attendances per 1000 registered patients/year | £7879c | £94c | 1.2% |
| GMS practices, with MPIG, values for capitation funding only | n/a | £6982c | n/a | n/a |
| GMS practices, with MPIG, values for capitation supplement (MPIG) only | A&E attendance per 1000 registered patients Emergency admissions per 1000 registered patients/year | £5720d | £747d £5531d Total: £6278d | 110.0% |
| PMS practices | n/a | £8443c | n/a | n/a |
↵a Modelling was only conducted if regression model coefficients were significant, P<0.05.
↵b Worked example: for the practice sample, ‘GMS practices, no MPIG’: the cost of a notional 10% change in secondary care utilisation is calculated as follows: 10% × £78.79 (mean capitation payment per registered patient) × 0.09 (B coefficient from regression model) × £132.00 (outpatient attendance per patient, reference cost) = £93.60 (or £94, to nearest whole number). The modelled saving is calculated as follows: £93.60 (cost of modelled saving in secondary care utilisation) × 100 ÷ £7879 (cost of notional 10% increase in general practice capitation funding) = 1.2%.
↵c Financial modelling based on 10% increase in capitation payments.
↵d Financial modelling based on 100% increase in capitation supplement. GMS = General Medical Services. MPIG = mean practice income guarantee. PMS = Personal Medical Services.