Some of our readers may know, that last year the Independent Hospital Pricing Authority (IHPA) tendered to engage a suitably qualified consultant (or consortium) to undertake a mental health costing and classification study and to develop the national Activity Based Funding (ABF) mental health classification system, which was scheduled for implementation by 1 July this year. The implementation date for the Australian Mental Health Classification was subsequently revised to 1 July 2016, because of the complexities involved in the development of the classification for mental health.
An open tender process for this project was conducted between October and November 2013, however, no suitable responses were received and the process discontinued. The statement of requirement was refined to cover the costing aspect only and a limited tender process was conducted in December 2013. HealthConsult was the preferred tenderer. HealthConsult will be required to provide the draft final report and mental health costs dataset by March 2015, with the final report and the final study infrastructure due by April, 2015.
IHPA is responsible for overall management of the project supported by a Mental Health Costing Steering Committee to oversee the design, compilation, and implementation of the costing study. The Steering Committee will operate until 30 June 2015. It is anticipated that the costing study will involve at least 9 pilot sites, at least 3 of which will be private psychiatric hospitals. The National Mental Health Service Planning Framework is also going to be used.
The Mental Health Costing Steering Committee will work with IHPA and its Mental Health Working Group to:
- Assist in the development of the data request specification
- Refine the proposed costing methodology
- Refine the proposed framework for the ideal sample of participating hospitals
- Actively engage of hospitals and hospital staff for the duration of the project
- Assist in addressing issues as they arise
- Provide feedback on data samples and the final dataset
- Provide feedback on written reports as required.
In May, IHPA released a consultation paper regarding the processes that are proposed to conduct the mental health costing study.
The consultation paper was prepared by a consortium led by the HealthConsult as a component of their work on the mental health costing study. The paper provided an overview of key issues for consideration and posed a series of focused consultation questions. Members of the public and all interested parties were invited to make submissions by 30 May 2014.
The AMA submission to IHPA argued that current funding for mental health services is inadequate, so if the Cost Study starts from this very low base, it will inevitably lock in place extremely low funding for mental health services, in perpetuity, no matter how robust its methodology. This is not the way to ensure public hospitals have sufficient resources to meet community need for public mental health services.
With that overall caveat, the AMA submission welcomed the Costing Study and supported the broad approach and processes proposed to undertake it. The AMA also supported the inclusion of consultation-liaison services in the Study. Consultation-liaison services provided by psychiatrists are an essential part of modern medical care. Typically these services are provided to patients in the hospital who are under the care of medical practitioners other than psychiatrists but who during their hospital admission require psychiatric care. These patients will attract funding to the main team looking after them (eg surgery) and because they may not attract a psychiatric diagnosis, there is no explicit funding for the psychiatric service involved in the hospital. The AMA agreed that consultation-liaison services provided by specialist mental health clinicians should be a distinct service to be counted and costed in the study, in the manner proposed in the consultation paper.