Expert Panel on effective ways of investing in Health,
Commissioning from private providers
Different policy instruments can be used to improve the performance of health care systems. One of those instruments is commissioning health care services from private providers, which appears to be increasingly used in the European context. Commissioning is defined is this report as a proactive and strategic process for the planning, purchasing and contracting of health services.
In this report, we highlight some important principles as well as practical considerations related to commissioning. We illustrate these with examples of commissioning in European countries, both successes and failures, with a focus on the experiences from Sweden and the UK.
Commissioning from (private) health care providers is a policy option that needs to be carefully compared to alternative policy options and evaluated in terms of costs and benefits, both short and long term. Whether benefits outweigh the costs depends on many contextual factors, including market structure, measurability of quality, good payment structures, etc. It is crucial to optimally align private providers with the goals of the health care system.
Success in commissioning from private providers requires professionalism and experience on the side of buyers and providers. This stresses the need for careful and evaluated introduction of commissioning, whenever deemed beneficial in attaining health care goals.
The knowledge base regarding commissioning from (private) providers in European health care systems is limited and stregthening this is encouraged.