ABF: Maintaining the rage
John Pilla, Director, National Health Care Practice
Lisa Strickland, Associate Director, National Health
Care Practice
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1
Overview
Background
National ABF: impacts to date
Critical dependencies
Strategies that work
Continuing and challenges
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2
Background
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name, logo and "cutting through complexity" are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
3
Why national ABF?
Ideology
Transparent mechanism for Commonwealth to
contribute more to increasing demand for hospital
services
Ensure that the Commonwealth’s contribution would be
for efficient care
A mechanism to partly offset the cost of reform
To make more explicit the Commonwealth’s financial
risk in avoidable hospital expenditure
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name, logo and "cutting through complexity" are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
4
National ABF:
impacts to date
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name, logo and "cutting through complexity" are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
5
Vastly improved ABF infrastructure
Classifications
Costings
Improved…
Knowledge &
understanding
Availability of data
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6
Emerging evidence of impacts
Improved efficiency over and beyond efficiency being driven
through fiscal policy
Improved budget management at all levels
Financial sustainability
Potential quality of care benefits
Transparency at clinical level
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Perhaps its greatest achievement
Catalyst for new thinking about performance
management
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name, logo and "cutting through complexity" are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
8
Critical dependencies
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name, logo and "cutting through complexity" are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
9
Critical dependencies
Alignment between national and state ABF arrangements
LHN capacity and capabilities
Flexibility that allows LHNs to reform
Clinician engagement
Support mechanisms
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name, logo and "cutting through complexity" are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
10
Strategies that work &
challenges
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name, logo and "cutting through complexity" are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
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Strategies that work
Reorientation of thinking:
Activity drives revenue
Skilled workforce
Systems and
technical support
Full alignment:
budget with performance
What
works…
Engagement and education
Transparency:
internal and external
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name, logo and "cutting through complexity" are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
12
Continuing and challenges
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name, logo and "cutting through complexity" are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
13
ABF has come a long way but…
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name, logo and "cutting through complexity" are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
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What needs to continue?
Investment in ABF infrastructure:
•
National developments
•
State/Territory supports
•
LHN innovation
Integration of ABF into performance management:
•
National
•
Jurisdictional
•
Health Service
Investment in performance methods:
•
Data analytics
•
Clinical costing
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name, logo and "cutting through complexity" are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
15
What are the challenges?
Ensure that ABF remains relevant to the reform agenda
Jurisdictions need to maintain the integrity of ABF
Hospitals need to continue with ABM
Keeping clinicians engaged and on side
Workforce regeneration and up-skilling
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name, logo and "cutting through complexity" are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
16
The new frontiers
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name, logo and "cutting through complexity" are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
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Do we dare to be brave?
Pricing
• Move away from average cost to efficient cost based
pricing
Payments
• Bundled payments
• Value based
• Consumer directed care
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name, logo and "cutting through complexity" are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
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