Ministry Conducts External Review of Funding Model

The Ministry of Health is hiring a consultant to conduct an external review of the population-based needs funding model. According to their documents, the review will take place later this year. In a Request For Proposal issued on March 4th:

“The Ministry of Health (the Ministry) is seeking to retain a qualified firm or individual(s) to provide professional services necessary to conduct a review of the Ministry’s Population Needs Based Funding (PNBF) Model, used to allocate operating funds for the acute, residential, and community sectors to the five regional health authorities. Request-for-Proposal

The successful proponent(s) will examine the key components of, and inputs to, the PNBF model: the estimate of the need of the population for these health care services; how the model accounts for differences in costs of providing care in rural/remote areas and large complex facilities; and, a comparison of the Ministry’s current approach to other available funding model alternatives. The successful proponent will provide a recommendation regarding the most appropriate approach that the Ministry could employ to make changes to the PNBF model, based on the approved principles. Proponents may bid on this review working as a team or individually.

The term of the Contract is expected to be from May 2014 to October 2014″

The BCCPA has asked the Ministry of Health to become an active participant in the review, as it could have impact on future funding within the continuing care sector. The RFP also states:

“The Ministry is currently engaged in a process of reviewing the mechanics of the PNBF used by the Ministry to allocate a significant portion of the operating funds to the five regional health authorities in the province of British Columbia.  The Ministry is committed to a transparent and objective process for reviewing the current PNBF model. This process is to ensure that the Ministry has the most appropriate model available, based on the approved principles, to allocate operating funds to the regional health authorities.”

Under the requirements heading, the document goes on to state “the Ministry is seeking to retain a qualified firm or individual(s) to provide professional services necessary to conduct an objective review of the PNBF model:

– Compare the Ministry’s current approach to cost differentials to other available alternatives.

The following questions should be specifically addressed in the written report:

  • Does the model need to adjust or differentiate for cost differences, for example, to reflect for the rural or remoteness, number, size of facilities or for the cost of providing services not specifically reflected in the current utilization rates (i.e. ambulatory care)?
  • Estimating and adjusting for a regional population’s need for health care services – What are the weaknesses in the current PNBF model of using population size, gender, age structure, Health System Matrix population stratification, and utilization of health care services to estimate and adjust for a regional population’s need for health care services? How could these weaknesses be addressed or overcome?
  • Adjusting for inter-regional flows – What are the weaknesses in the current PNBF model of adjusting for the inter-regional flow of patients, and how could these weaknesses be addressed or overcome?
  • Adjusting for rural and remoteness factors – What are the weaknesses in the current PNBF model of adjusting for cost differences related to rural and remoteness factors, and how could these weaknesses be addressed or overcome?
  • Adjusting for complexity factors – What are the weaknesses in the current PNBF model of adjusting for cost differences related to complexity (i.e. the adjustment for cost differentials between large/small, teaching/non-teaching and urban/rural facilities)? How could these weaknesses be addressed or overcome?
  • Other factors – Are there other factors causing cost differentials, and how should those factors be adjusted for in the funding allocation model?
  • Annual updating – The current model is up-dated each year, which tends to result in changes to the funding allocation percentages for each regional health authority. What is the best approach for dealing with these annual changes?
  • A comparison of the Ministry’s current approach to alternatives used in other jurisdictions, e.g. based on a per capita approach.

To download a copy of the Ministry of Health RFP, please login to the Member’s Only section of our website where additional information regarding this review will also be posted in the coming weeks.