Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Applying Principles for Outcomes-Based Contracting in a Public Health Program

Honoré, Peggy A. DHA, MHA; Simoes, Eduardo J. MD, MSc, MPH; Moonesinghe, Ramal PhD, MA, MS; Kirbey, Harold C. BS; Renner, Meg MEd

Journal of Public Health Management and Practice: September-October 2004 - Volume 10 - Issue 5 - p 451–457

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.

This article documents initial efforts to implement basic principles for outcomes-based contracting in a state public health department program to assist in meeting the challenges of improving program results while documenting the benefits of government spending.

Director, Office of Health, Mississippi State Department of Health, Jackson; an Adjunct Assistant Professor, Medical University of South Carolina, Charleston; and Visiting Scholar, Rollins School of Public Health, Emory University, Atlanta, Georgia (Honoré).

Director, Prevention Research Centers Program, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia (Simoes).

Statistician, Public Health Program Practice Office, Centers for Disease Control and Prevention, Atlanta, Georgia (Moonesinghe).

Chief, Primary Care and Rural Health Unit, Section of Community Health Systems and Support, Division of Community Health, Missouri Department of Health and Senior Services, Jefferson City (Kirbey).

Director, The Rensselaerville Institute, St. Louis Office, Missouri (Renner).

Corresponding author: Peggy Honoré, DHA, MHA, 570 East Woodrow Wilson, PO Box 1700, Jackson, MS 39215-1700 (e-mail:

© 2004 Lippincott Williams & Wilkins, Inc.