ABSTRACT
This chapter focuses on impact bonds, a form of Payment-by-Results that seeks to leverage capital from private, philanthropic and/or third-sector investors to fund social and public services. We first introduce impact bonds and the arguments for and against them, before focusing on a particular subset of impact bonds – health impact bonds. Impact bonds are a new way to fund health(care) services and interventions and potentially act on determinants of health. However, we do not have a clear sense of their nature and reach in regards to health. In the second half of the chapter, we present the results of a mapping exercise that provides a clearer sense of how many health impact bonds exist, where they operate in the health system, what they focus on and what indicators trigger payments. We then discuss whether health impact bonds have untapped potential or represent a broken promise and if they target the source, or effects, of the problem.
