By NextBestFitEquity-adjusted funding
Add payments for providers serving deprived areas, based on a deprivation index.
Extra pay for deprived areas.
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This path
Equity-adjusted funding
Concrete changes if chosen
What would actually have to change in law, agencies, payment rules, or systems.
- Add deprivation-index payments to provider rates
Effects
Each effect has its own page: the evidence, the case that it is or isn't a real cost, and whom it affects.
What it fixes
- Racial, income, and geographic disparities
Additional payments based on area deprivation direct money toward the greatest needs and support safety-net providers.
What it creates or worsens
- Directs benefits or burdens imperfectly
Deprivation-based payments rely on imperfect indices to allocate funding.
- Reduces income or business for affected groups
Deprivation-based payments leave providers in wealthier areas receiving less.
Who's affected
Who gains
- Black, Hispanic, and Native communities
- Racial, income, and geographic disparities: Access and outcomes differ by race, income, and location.
- Rural residents
- Racial, income, and geographic disparities: Access and outcomes differ by race, income, and location.
- Low- and middle-income households
- Racial, income, and geographic disparities: Access and outcomes differ by race, income, and location.
- Hospitals, clinics, and care organizations
- Racial, income, and geographic disparities: Additional payments based on area deprivation direct money toward the greatest needs and support safety-net providers.
Who loses
- Hospitals, clinics, and care organizations
- Racial, income, and geographic disparities: They can select better-paying patients over those with lower-paying coverage.
- Hospitals and specialist groups with high private prices
- Directs benefits or burdens imperfectly: Deprivation-based payments rely on imperfect indices to allocate funding.
Where it has been tried
- NHS England: Allocation formula includes deprivation.
- England, United Kingdom: For 2023–2024, NHS England's core funding formula gave health inequalities and unmet need a 10.2% weighting.Sources: NHS England (2023)