PbR compensates Trusts based on the volume of their activity and mix of health care provision, according to a national tariff system. For a gradually increasing share of their activities, it will gradually replace the old block grant system that was based on historical revenues.
PbR potentially gives Trusts greater revenue flexibility, enabling them to be paid more for additional activity.
Conversely, it could also penalise the Trusts with higher costs than can be remunerated under the national tariff. (The national tariff, which has been calculated by the DoH for these purposes, does allow for minor regional variations and additional compensation for specialist care providers.)


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