Capital rates are developed according to local costs and the average use of services and may therefore vary from one region of the country to another. Many plans set risk pools as a percentage of the capita payment. In 2014, one of the authors (Jacobs, 2014) wrote an article for BJPsych Advances that details a new funding method introduced by the English National Health Service for mental health care providers. This approach, then called “payment by Results” (PbR), was to be a fundamental change in the way psychiatric service providers are paid to care for patients. Our research has shown that commissioners welcome the cluster of care model (Jacobs et al., 2016) and use it as a framework for understanding and discussing care patterns and local variations.