This paper explores the feasibility of funding community rehabilitation services based on the outcomes that interventions produce. Community rehabilitation services are most often paid for by the number of client visits or the specific services delivered. Neither of these two methods incent interventions that help to keep patients from accessing more costly upstream acute services such as acute and emergency care.
Preventing patients from unnecessarily accessing costly acute services and shortening the length of stay in care are of principal concern to Alberta Health Services (AHS) and the provincial government. As the cost of health services continues to rise, administrators and health policy planners need to look at alternative ways of funding services in order to gain efficiencies and invest in services that prevent a more costly alternative of care.
The Social Impact Bond (SIB) is a promising newly piloted type of funding contract that is based on payment for specific outcomes that negate the utilization of more costly care. One of the main benefits of the SIB is that the capital needed for funding services is provided by private investors who have an interest in the population that the program is targeting. However, like any type of funding mechanism that is contingent on outcomes, paying for outcomes in health is challenging due to the complexity of identifying clear performance measures, accessing proper data, and meaningfully measuring change.