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Outpatient pilot for Activity-Based Funding commences

Until now, only inpatient and day case procedures have been funded through the model, which was introduced in 2016 to connect hospital funding with activity.

The ABF budget for 2018 is €5.657 billion, which is €180 million greater than last year’s budget.

The outpatient pilot project is taking place across 10 hospital sites and the results will determine the future extension of the ABF model.

Also this year, the number of hospitals within the ABF programme will increase to 42 from the existing 39, while initiatives will continue to try to improve the quality of the data underpinning the funding model.

Last year, a best practice tariff was introduced on a pilot basis for hip fracture surgery.

The purpose of this initiative is to reduce variation in clinical practice and incentivise best practice through adherence to Blue Book standards for hip fractures. It follows a piece of work by the National Clinical Programme for Trauma and Orthopaedics (NCPTO) in collaboration with the ABF Programme in the Healthcare Pricing Office (HPO). 

For each hip fracture procedure that meets all six criteria based on data from the Irish Hip Fracture Database (IHFD) and subject to data validation, an additional payment of €1,000 over and above the Diagnostic Related Group (DRG) price will be made.

Incentivising hospitals to move inpatient laparoscopic cholecystectomy from inpatients to day cases has also been introduced through pricing structures. This is the first time that such an incentive is being implemented in the ABF funding system.

“This initiative will act as a signal to the healthcare system that ABF will be used to support clinical initiatives relating to care pathways, appropriate care setting and quality,” a HSE spokesperson told the Medical Independent.

The QlikView tool, which allows for hospitals and clinicians to monitor their activity against targets, also continues to be rolled-out.  “We further developed patient-level costing software, appointed more clinical coding staff, more data analysts and new clinical coding managers to link with clinicians and improve data quality in coding of cases and further developed the skillset within the Healthcare Pricing Office through learning exchanges with the Independent Hospital Pricing Authority in Australia,” the spokesperson added.

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