Towards Population-Based Funding for Health: IGEES Spending Review 2022 Model Proposal
The Irish Government Economic and Evaluation Service (IGEES) presents a model proposal for implementing Population-Based Resource Allocation (PBRA) in the healthcare sector. The proposal aims to distribute funding equitably among Regional Health Authorities (RHAs) based on population needs and cost of care services. Key findings suggest the use of a needs-adjusted capitation model and provide recommendations on governance and management of the PBRA model.
Download Presentation
Please find below an Image/Link to download the presentation.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author. Download presentation by click this link. If you encounter any issues during the download, it is possible that the publisher has removed the file from their server.
E N D
Presentation Transcript
IGEES Irish Government Economic and Evaluation Service Spending Review 2022 Towards Population-Based Funding for Health: Model Proposal Conor O Malley, Tiago McCarthy, Andrew Hannigan, Niamh Buckle Department of Health March 2023
Spending Review 2022 Overview, Aims & Objectives Overview PBRA is a funding model with the objective of fairly distributing available funding between RHAs according to the relative needs of their populations and the relative cost of providing health and social care services to meet those needs. Aims and Objectives The Spending Review; Further contributes to the evidence building required for the consideration of the most appropriate PBRA model to be implemented in 2024. Informed by the findings of McCarthy et al., (2022) and Johnston et al., (2021) this paper proposes a preliminary PBRA model for implementation. Demonstrates preliminary results showing the share of expenditure going to each RHA by programme level from 2016 2021, and guideshares derived from the model. Presents recommendations as to how PBRA should be governed and managed. 2 Rialtas na h ireann | Government of Ireland
Spending Review 2022 Key Findings This paper recommends the use of a needs-adjusted capitation model to allocate funding to the RHAs. The model adjusts RHA population shares by an Age-Sex Index, a Deprivation Index, and a Rurality Index. It is recommended that only HSE Acutes and Community expenditure be subject to the PBRA over the short to medium term. The results of the PBRA model applied in this paper point to guide PBRA expenditure shares being similar to the current budget allocation by RHA. Based on international best practice, several recommendations are made regarding the governance, management, and updating of the PBRA model. These include; A permanent Advisory Group for the design and monitoring of the PBRA model. A Secretariat to conduct in-depth analysis and assist in improvement of the model. All work related to these groups should be made publicly available in the form of detailed published reports. 3 Rialtas na h ireann | Government of Ireland
Spending Review 2022 Key Findings Gross Primary Care Expenditure by RHA Gross Acute Care Expenditure by RHA 24.2% 23.0% 23.0% 21.7% 25.0% 25.0% 20.9% 20.9% 20.6% 20.7% 20.2% 19.5% 19.3% 19.3% 18.9% 19.0% 19.0% 18.9% 18.6% 18.4% 17.6% 17.6% 16.6% 20.0% 16.3% 20.0% 14.8% 14.8% 14.4% 14.4% 14.1% 14.3% 14.2% 13.1% 15.0% 15.0% 10.9% 8.4% 8.5% 8.0% 7.9% 8.0% 10.0% 10.0% 5.0% 5.0% 0.0% 0.0% A B C D E F A B C D E F 2021 - % of Total Primary Care Expenditure 2021 - % of Population PBRA Model 2021 - % of Total Acute Gross Expenditure 2021 - % of Population PBRA Model Estimated allocation of funds subject to PBRA, 2021 funding ( m) RHA A 1,672 152 46 19 211 206 2,306 RHA B 1,422 159 62 33 170 171 2,017 RHA C 1,213 166 14 9 194 181 1,777 RHA D 905 123 21 14 139 155 1,357 RHA E 545 95 11 13 76 93 833 RHA F 1,144 169 10 16 187 193 1,719 Acute Primary Social Inclusion Palliative Mental Health Older Persons Total 4 Rialtas na h ireann | Government of Ireland RHA A: Dublin North Central, North West Dublin, North Dublin, Meath, Louth, Cavan/Monaghan.RHA B: Dublin South City, Dublin South West, Dublin West, Kildare/West Wicklow, Laois/ Offaly Longford/Westmeath.RHA C: Dublin (South East), Dun Laoghaire, Wicklow, Wexford, Carlow/Kilkenny, Waterford, South Tipperary. RHA D: West Cork, Cork South Lee, Cork North Lee, North Cork, Kerry. RHE E: Limerick, Clare, North Tipperary/East Limerick. RHA F:Galway, Roscommon, Mayo, Sligo/Leitrim, Donegal
