Health System Funding Reform2014-15 Funding Release – HNHB

“Dramatically improving the patient experience through Quality, Integration and Value”

Audit Committee MeetingOctober 29, 2014

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Outline

• HSFR Roll-Out Plan for Hospitals• HSFR Overview• 2014-15 HSFR Summary• Pre-Mitigation Funding Calculation

• The Health Based Allocation Model (HBAM)• The Quality Based Procedure

• Mitigation Funding Calculation• Impact Analysis Workbook Review• Funding Impact Analysis• Support Resources• Q&A Session

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Releasing HSFR Funding Information

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Change is Necessary

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Health System Funding Reform

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Health System Funding Reform

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HSFR ImplementationHSFR Phased-in Over Time

Example: Hospital Changes Over Time

Pre-HSFR Current Full Implementation

QBP

Global Funding HBAM Global

Funding

QBP Global

Funding

HBAM

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Quality Based Procedures

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2014-15 HSFR Summary

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2014-15 HSFR Summary

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2014-15 QBP Methodology Updates

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2014-15 QBP Approach

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Other Methodology Updates

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What is HBAM?• HBAM is an evidenced-based, health-based funding formula.

• HBAM estimates future expense levels based upon past service levels and unit costs, as well as population and health information.

• Population information includes:• Age, Gender, Growth Projections, Socio-Economic Status

(SES), Rural Geography

• Health information includes indirect measures and health status• Care-type specific diagnostics and procedural information

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HBAM Overview

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HBAM – Expected Results

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QBP Funding Calculation & Allocation

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2014-15 Mitigation Funding

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HNHB Results – 2014-15 - Hospitals

A B C D E F G H

Hospital HBAM

LHIN Managed

QBPs Subtotal Endoscopy Chemotherapy CKD HSFR Total( B + C ) ( D + E + F + G )

St Catharines Hotel Dieu (197,638) 67,161 (130,477) 0 0 0 (130,477)Grimsby West Lincoln Memorial 104,745 125,479 230,224 0 0 0 230,224Burlington Joseph Brant Memorial (790,841) 450,654 (340,187) 72,861 422,005 0 154,679Simcoe Norfolk General Hospital 3,679 91,195 94,874 190,915 0 0 285,789St Catharines Niagara Health System 7,912,408 305,742 8,218,150 (969,814) 385,513 251,780 7,885,629Brantford Brant Community Health System (463,349) 1,975,304 1,511,955 (75,607) 53,747 0 1,490,095Hamilton St Joseph's Health Care 2,086,416 (2,604,720) (518,304) (757,261) 0 1,368,166 92,601Hamilton Health Sciences Corporation (235,856) 6,137,939 5,902,083 (165,378) (98,593) 0 5,638,112

HNHB TOTAL 8,419,564 6,548,754 14,968,318 (1,704,284) 762,672 1,619,946 15,646,652

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HNHB Results – 2014-15 - CCAC

• Mitigation Remains in CCAC Sector: -1% to +3%

• HBAM represents approximately 30% of total funding allocation

2014-15 HBAM Impact (2,888,128)2014-15 QBP Impact 240,376

Pre-Mitigation Impact (2,647,752) -3.51%2014-15 One-Time Mitigation 1,892,4102014-15 HSFR Impact (755,342) -1.00%

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Small Hospitals• Fewer than 2,700 acute inpatient and/or day surgery

weighted cases in any two of the prior three years of the most recent data

• Two Hospitals in HNHB

1. Haldimand War Memorial Hospital

2. West Haldimand General Hospital

• Continue to receive funding on Global basis (no HBAM or QBP)

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Thank you