الأربعاء، سبتمبر ١٤

Use of Casemix in funding


Use of Casemix in funding
At present NSW Health utilises a funding allocation process to Areas based on the population's needs, on recurrent expenditure requirements of new facilities and developments in Commonwealth funding arrangements.  This is known as the Resource Distribution Formula.  The funding provided to Areas is largely provided as a global allocation and decisions about funding of individual institutions are made locally by the Area.
In order to make these allocation decisions more equitable and standard across the state, the NSW Health Council recommended the introduction of episode based funding for acute services from July 2000.  The model calculates funding from Areas to Hospitals and is a prospective payment based model with payment calculated on each hospital’s projected activity and adjusted for case types such as day only patients, transferred patients, long stay outliers and the public / private mix.  Payment is calculated using state hospital peer group benchmark prices.
There is the intention in future years to expand the model to incorporate funding for Emergency Services, Intensive Care, Mental Health and Rehabilitation and Extended Care services.  These services are currently funded on an historical basis.
To further expand on the use of Casemix principles in funding, the Area decided to implement the Contract Payment Advisor (CPA) module of TRENDSTAR.  The four month project commenced in March 1999 and now provides the Area with the ability to simulate funding to individual hospitals using the principles of episode based funding.  CPA provides hospitals with the ability to report actual cost and activity against payment and to model new funding contracts and scenarios.

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