Patient Level Activity Based Costing
Patient Level Activity Based Costing
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At Healthcost, we take a ‘bottom-up’ approach to costing – our focus is not HRG’s or Specialties, but the patients themselves and the resources consumed during their episode of care.
At Healthcost, we employ our knowledge, skill and experience to connect the dots for a hospital. We take the individual patient level feeder systems and link the resources consumed directly to patients. This process sees us undertake quality checks of the data, which focuses Trusts on the improvements to data they need to undertake. This key piece of work is by necessity, a bespoke solution for all of our sites and one which sees,in many Trusts, millions of transactions mapped to hundreds of thousands of patients on a basis that is replicable and reliable.
When thinking about patient level costing, some Trusts may baulk at the prospect over the perceived quality of their patient level data. At Healthcost, however, we are not hampered by poor quality data or even a complete absence of datasets (e.g., Pathology). Our considerable experience in many hospital environments across the world has led us to develop proxy cost allocation mechanisms that still drive costs accurately to patients and gain the acceptance of hospital managers and clinicians alike.
It is a fact that the primary function of all hospitals is to diagnose and treat patients. It is also a fact that clinicians make the decisions surrounding diagnosis and treatment. Clinical input into – and acceptance of – the costing process cannot be understated, for the simple reason that it is primarily clinicians who decide what resources patients will consume during their episode of care (length of stay, drugs, prostheses, theatre, imaging, pathology e.t.c.). It is crucial that clinicians understand and accept the costing methodology and have access to data that identifies resource utilisation at the patient level, because it is they who will be able to identify ways to minimise waste in the delivery of care to patients.
At Healthcost, we believe strongly in bringing clinicians into the costing process and encourage Trusts to look for clinical champions in this area. Part of our implementation always focuses on obtaining clinical input into and acceptance of the ways that we allocate medical and nursing costs.
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For more information on detailed allocation methodologies, please contact us for a demonstration.
Consulting
Healthcost’s staff are recognised Casemix experts whose services are sought in many countries around the world. We provide expert advice on all Casemix related issues, from coding reviews, to assisting with funding policy development. We have worked with organisations such as the World Bank, and government departments and health insurers in Australia, Ireland, Slovenia and Turkey. One of our strengths is that we are completely health focussed - and our management team has worked exclusively in the health sector for the past 15 years.
International Benchmarking
Healthcost is the only company in the United Kingdom capable of benchmarking NHS Trust cost and other key performance indicators on an international basis. In 2007 we invested in an exercise to map the UK’s OPCS codes to Australian procedure codes. This has enabled us to group UK patient data to Australian Refined Diagnosis Related Groups (AR-DRGs). AR-DRGs are an internationally recognised classification and used by many countries such as Australia, Germany, New Zealand, The Republic of Ireland, Singapore, Slovenia, Turkey, and Romania. The classification is also being trialled in China. We have successfully benchmarked two UK Trusts against some of our client hospitals in other countries, with very positive results. We look forward to extending this service to all of our clients throughout 2008.