The Milestone Payment System: Results based funding in vocational rehabilitation – 2005

Abstract

As State budgets tighten, Vocational Rehabilitation (VR) Agencies and Community Rehabilitation Providers face a daunting challenge to collaboratively craft methods to improve the efficiency and effectiveness of community-based employment services while preserving consumer informed choice. Results Based Funding methods push service systems in the direction the consumer chooses by creating incentives for consumer valued outcomes. Alternatively, hourly funding can push in the wrong direction, with incentives for more service activity, thereby unintentionally generating outcome interference for both the provider and the customer. Milestone funding systems have been shown to improve outcomes for consumers while simultaneously increasing the number of successful rehabilitations for the VR agency. Service providers have successfully learned to shift the focus of their work from process and activities to outcomes and results. This article discusses the key elements that make a Milestone or Results Based funding strategy successful.