Government & policy

BC implements patient-based hospital funding

VANCOUVER – Patients will benefit from more timely, accessible care as British Columbia invests an additional $250 million over the next two years to launch its patient-focused funding model to the 23 largest hospitals across the province, announced Health Services Minister Kevin Falcon.
 
“Our new approach builds on the success of the pilot projects implemented through the Lower Mainland Innovation and Integration Fund, which proved patient-focused funding can improve access for patients for everything from emergency care to breast cancer treatment,” said Falcon. “Patient-focused funding is part of our broader innovation and change agenda to improve patient care while managing growing healthcare costs and preserving our public healthcare system for our kids and grandkids.”

Currently, the overwhelming majority of funding for health authorities from the Ministry of Health Services is through block funding, which is not attached to specific targets or priorities. Under a patient-focused funding approach, hospitals receive financial incentives for delivering acute-care services for a competitive, set price.

Falcon said in each of the pilot projects there was better management of resources and dollars by hospitals and health authorities – and most importantly, more timely quality care for patients. For example, shorter wait times for breast cancer diagnosis and spinal surgery, increased hip- and knee-replacement surgeries and being seen faster in emergency departments to aid decongestion. The ministry is taking patient-focused funding and incorporating it for all health authorities.

Over the next two years, the Province will invest an additional $250 million to implement province-wide patient-focused funding – $80 million in 2010-11 and $170 million in 2011-12. Patient focused funding will be gradually expanded, and by 2012-13 around 20 percent of eligible acute-care spending will be funded through this approach.

The ministry has registered the BC Health Services Purchasing Organization to oversee the implementation of patient-focused funding. The organization builds on the successes of the $75-million Lower Mainland Innovation and Integration Fund.

The objectives for the end of the first year include:

• Expand emergency department patient-focused funding in hospitals.
• Reduce wait times in selected common surgical procedures.
• Increase same-day surgical procedures by reducing overnight stays.

“We have already seen the value of patient-focused funding and innovation in healthcare across the Lower Mainland,” said David Thompson, chair of the new BC Health Services Purchasing Organization and outgoing chair of Vancouver Coastal Health. “Thousands of patients have benefited from decongestion in emergency departments and reduced wait times for surgery. We hope to build on that province-wide.”

Results from the Lower Mainland Innovation and Integration Fund included reducing congestion in emergency departments in Vancouver by up to 25 percent, reducing wait-lists for foot and ankle surgery and spinal surgery and dramatically improved access to four rapid-access breast cancer clinics for women in the Lower Mainland to identify potential cases of breast cancer quicker.

At the UBC Hospital Centre for Surgical Innovation, successes included performing more hip and knee joint replacement surgeries as a result of increased efficiencies such as cost reductions per surgical case and a drop in the length of hospital stay for patients.

Patient-focused funding will provide financial incentives to health authorities to promote a shift from inpatient services to same-day surgical procedures where appropriate to help reduce wait times in high-demand areas. The funding incentive will also promote more cost-efficient and innovative practices such as in emergency departments, while maintaining the highest level of care possible. The purchasing organization will also provide incentives at the hospital level to encourage and improve upon existing quality levels of care.

“British Columbia continues to be number one in Canada when it comes to surgical wait times, according to recent data from the Canadian Institute of Health Information and the Wait Time Alliance,” said Falcon. “However, we can improve patient care and further reduce wait times by learning from other jurisdictions across the world that have successfully implemented patient-focused funding.”

Expansion of patient-focused funding is part of the province’s strategy to drive quality healthcare services that are appropriate, safe and effective. The strategy may expand to eventually include providing incentives for health authorities to better manage frailty, chronic disease and mental illness through community care rather than in a hospital or residential-care setting, as well as meeting demand for elective surgeries through reduced hospital inpatient surgery and increase day surgeries in hospital and surgical clinics.

Posted April 22, 2010