Structuring a framework for performance-based budgeting in public health

Questica icon


A Georgia-based case study published in the Journal of Public Health Management and Practice notes that the ability of public health to meet its functional mandates of assessment, assurance, and policy development is driven by the system’s capacity to meet basic financing needs. To do so, state and local public health leaders must be able to articulate financing needs in terms that are clear to policy makers. They must also be able to link funding to anticipated community impact, benefit, and performance. “Rational” budgeting demands, imposed by performance-centered budgeting, have proved particularly challenging for public health programs. The aforementioned case study explores one approach to program budgeting in state and regional public health systems and finds the framework to be normatively sound and appropriately descriptive of the “core functions” of public health.


The study concludes that going forward, a clearly defined performance budgeting system that links funding to programs, and thereafter programs to accomplishments, could assist policy makers in better understanding the importance and effectiveness of public health systems. The first step in this process is to establish program budgets, by capturing expenditures and revenues within those program areas. The study finds that public health funding and expenditures can be categorized descriptively and explained with clarity, providing a framework to support program budgeting and performance measurement. Once the framework is in place, policy makers and public health professionals may begin the important discussions needed to establish performance measures and priority outcomes.


Performance-based budgeting requires a rigorous system of fund-source budgeting and reporting that is often unavailable in conventional budgeting and financial management systems. Both Questica Budget and Performance represent proven COTS (commercial off-the-shelf) software solutions that are not only flexible and scalable, but also maintain security and regulatory compliance.


Questica Budget is a web-based budgeting tool that provides a controlled environment for budget input, review, approval, and maintenance. It offers one point of data entry and seamless integration into a hospital’s existing financial system. Questica Performance allows public health systems to establish and manage objectives, leveraging financial and statistical data from any number of sources to effectively measure performance. It allows public health leaders to create a system of Programs (services) and Measures, as well as Scorecards to monitor and track the status of organizational goals.


If you would like to explore how to implement a performance-based budgeting, please contact us and request a demo of Questica’s solutions for healthcare.