The APS has had feedback from the Independent Hospital Pricing Authority (IHPA) following our letter in May 2014 and follow-up telephone discussions responding to concerns raised by our membership about the pricing classifications for outpatient pain management activities. Predictably the news is mixed – some positives but much future progress to be made.
Whilst our concerns relating to the incomplete and simplistic definitions of outpatient pain management activities have been taken onboard, IHPA is now undertaking further studies to better understand the broader picture of multidisciplinary outpatient services and cost implications. The implication is that the current study will take 1 – 2 years to complete but will result in more accurate classifications and hence valid funding outcomes. Interestingly, patient disease burden may become a significant component of cost analysis in the next iteration of outpatient service classification – emphasising the importance of the ePPOC data collection set.
In the interim, APS members are encouraged by IHPA to emphasise to their hospital finance managers that the current funding model is acknowledged by IHPA to be a very loose estimation of multidisciplinary pain service activities. The allocation of the same cost weight (resulting in an approximately $400 payment) for an outpatient attendance for a multidisciplinary assessment as occurs for being one member of a group program exemplifies the flaws in the current classification. Swings and round-abouts indeed!
The take-home message is to realistically continue to provide services to your patients according to best-practice and to avoid changing models of care to conform with the current (albeit temporary) funding model for outpatient activities. Avoid being pressured by finance managers to move away from same-day multidisciplinary pain assessment. Perhaps show them this article or better still refer them to IHPA for clarification. Get engaged with the data collection for the next IHPA costing study to ensure accurate information is recorded. And finally, don’t hesitate to relay any concerns to your APS board member or our secretariat – we do enjoy writing letters to IHPA and other commonwealth health organisations!
By Dr Tim Semple, MBBS FANZCA FFPMANZCA
Immediate Past President
Australian Pain Society
Tim is a pain medicine specialist and anaesthetist in the Department of Anaesthesia, Hyperbaric Medicine and Pain Medicine, Royal Adelaide Hospital having completing fellowship training in 1991.