Typically, the final round is a public concert featuring the finalists performing with orchestra.
After the final round, a winner is decided, who may receive an opportunity to perform the complete concerto with the orchestra in their next season.
They are often organised by the orchestra that accompanies the competitors as a way to attract audiences, but sometimes they are hosted by a university or conservatory, for the purpose of encouraging a higher standard of playing among its students, and for publicity.
For example, the Tchaikovsky competition has a final round in which competitors perform movements of concertos with orchestra, but previous rounds test the competitors on different repertoire; therefore it is not a concerto competition.
However, the average playing difficulty of a concerto is reasonably high; this, coupled with the fact that opportunities to play as a soloist with an orchestra are limited, make concerto competitions a local but advanced form of music competition.