Clustering in mental health payment by results: a critical summary for the clinician
Open accessAbstract
Summary Mental health payment by results (PbR) is a disruptive new prospective payment system intended to replace National Health Service block contracts in England and provide a mechanism for opening up the mental health economy. Patients are allocated to one of 21 treatment clusters, each with a different price or tariff. Clinicians perform cluster allocation using the Mental Health Clustering Tool. The clustering process makes demands on clinicians' time even with support from information systems. Clustering is novel and it is unclear how it will work in practice. The process is likely to be susceptible to gaming. LEARNING OBJECTIVES Understand that the clinical process of diagnostic classification is different from the financial process of clustering categorisation. Understand the importance of learning the clustering tool ratings definitions in order to make accurate cluster allocations. Recognise that mental health payment by results is driving the widespread adoption of outcomes measurement.
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Over the past ten years, the National Health Service has tried to implement an outcome-based reimbursement program in mental health care.
“Over the past ten years, the National Health Service has tried to implement a similar outcome-based reimbursement program in mental health care 68 .”
From Measuring and improving the quality of mental health care: a global perspective (2018) · cites this paper as [68]
Administrative burden and risk of gaming led to professional resistance, and the NHS mental health outcome-based reimbursement program has been indefinitely postponed in favor of smaller work areas.
“However, the administrative burden involved and the risk of gaming (i.e., biased reporting to improve apparent performance) has led to resistance from the profession 68,69 .The program has now been indefinitely postponed in implementation in favor of smaller areas of work 70 .”
From Measuring and improving the quality of mental health care: a global perspective (2018) · cites this paper as [68]
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- Authors
- Yeomans, D.
- Affiliations
- Leeds and York Partnership NHS Foundation Trust (GB)
- Corresponding author
- Yeomans, David
- Venue
- Advances in Psychiatric Treatment
- Publisher
- Cambridge University Press (CUP)
- Published
- 2014-07
- Volume
- 20
- Issue
- 4
- Pages
- 227-234
- ISSN
- 1355-5146 (ISSN-L)
- 1472-1481
- OpenAlex
- W2123975484
- Cited by
- 16
- References
- 7
- Citations by year
- 2026: 1 · 2025: 1 · 2023: 1 · 2021: 2 · 2018: 4 · 2017: 3 · 2016: 1 · 2015: 2 · 2014: 1
- FWCI
- 2.75
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Advances in Psychiatric Treatment (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Health Professions › General Health Professions › Health Services Management and Policy
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Keywords
- prospective payment system, cluster allocation, gaming, diagnostic classification, outcome measurement, clinician workload
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