Evaluating Outcome-Based Payment Programmes: Challenges For Evidence-Based Policy

We review the state of evaluation within outcome-based commissioning in the United Kingdom. This is the first review to include empirical evaluations of both PbR and SIB programmes. We find a paucity of evaluation and that the quality of evaluations is not high. Moreover, studies tend to conflate the outcomes-based commissioning mechanism with the intervention or services that are funded, and are unable to assess the contribution of these separate elements to impact. Our review also highlights the challenges faced by evaluators in measuring social outcomes. We suggest ways to address these challenges.