Applying principles for outcomes-based contracting in a public health program.

A national movement is underway for government agencies and their program implementation partners, such as contractors and grantees, to explicitly demonstrate the benefits acquired from the expenditure of public funds. Given such expectations, agencies have adopted initiatives, such as outcomes-based contracting, as quality improvement tools to facilitate performance improvements and to document results. When using outcomes-based contracting methods, payments are linked to accomplishment of mutually agreed upon results. Outcomes are not defined in terms of what is performed, but on the impact of what has been achieved. This case study documents the implementation of some fundamental principles for outcomes-based contracting in a state health department community partnership program. Results are also presented from an interview of contractors that participated in this new contracting process. Interview objectives were to document the impact of outcomes-based contacting on building collaborations and improving accountability. Results revealed perceptions of a highly collaborative relationship between the agency and contractors where contractors viewed outcomes-based contracting as improving accountability by focusing on results, establishing and monitoring performance targets, and facilitating contractor flexibility. Respondents also indicated strongly that under this contracting method, they utilized the funding more effectively by linking it with other community investments.