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Primary Health Care

Capitation Change Calendar 2007/2008


This calendar sets out this years key dates for upcoming payment processing system changes

2007
January
Feburary
March
Key
S
M
T
W
T
F
S
S
M
T
W
T
F
S
S
M
T
W
T
F
S
Holidays & Weekends
1
2
3
4
5
6
1
2
3
2
3
Key Date
7
8
9
10
11
12
13
4
5
6
7
8
9
10
4
5
6
7
8
9
10
14
15
16
17
18
19
20
11
12
13
14
15
16
17
11
12
13
14
16
17
21
22
23
24
25
26
27
18
19
20
21
22
23
24
18
19
20
21
22
23
24
28
29
30
31
25
26
27
28
25
26
27
28
29
31
April
May
June
S
M
T
W
T
F
S
S
M
T
W
T
F
S
S
M
T
W
T
F
S
1
2
3
4
5
6
7
1
2
3
4
5
1
2
8
9
10
11
12
13
14
6
7
8
9
10
11
12
3
4
5
6
7
8
9
15
16
17
18
19
20
21
13
14
16
17
18
19
10
11
12
13
14
15
16
22
23
24
25
26
27
28
20
21
22
23
24
25
26
17
18
19
20
21
22
23
29
30
27
28
29
30
31
24
25
26
27
28
29
30
July
August
September
S
M
T
W
T
F
S
S
M
T
W
T
F
S
S
M
T
W
T
F
S
2
3
4
5
6
7
1
2
3
4
1
8
9
10
11
12
13
14
5
6
7
8
9
10
11
2
3
4
5
6
7
8
15
16
17
18
19
20
21
12
13
14
15
16
17
18
9
11
12
13
14
15
22
24
25
26
27
28
19
20
21
22
23
24
25
16
17
18
19
20
21
22
29
30
31
26
27
28
29
30
31
23
24
25
26
27
28
29
30
October
November
December
S
M
T
W
T
F
S
S
M
T
W
T
F
S
S
M
T
W
T
F
S
1
2
3
4
5
6
1
2
3
1
7
8
9
10
11
12
13
4
5
6
7
8
9
10
2
3
4
5
6
7
8
14
15
16
17
18
19
20
11
12
13
14
15
16
17
9
10
11
12
13
14
15
21
22
23
24
25
26
27
18
19
20
21
22
23
24
16
17
18
19
20
21
22
28
29
30
31
25
26
27
28
29
30
23
24
25
26
27
28
29
30
31

2008
January
Feburary
March
S
M
T
W
T
F
S
S
M
T
W
T
F
S
S
M
T
W
T
F
S
1
2
4
5
1
2
6
7
8
9
10
11
12
3
4
5
6
7
8
9
2
3
4
5
6
7
8
13
14
15
16
17
18
19
10
11
12
13
14
15
16
9
10
11
12
13
14
15
20
21
22
23
24
25
26
17
18
19
20
21
22
23
16
17
18
19
20
21
22
29
30
31
24
25
26
27
28
29
23
24
25
26
27
28
29
30
31


Additional Updates


For additional updates to the Capitation Change Calendar, please visit the News page.

CPI Fast Track - Technical Summaries


Technical Summaries PMS v03 (Word, 155 KB)

CPI Fast Track - Key Dates


March 2007



1 March 2007

1. Additional quarterly status reporting to PHOs
Enhancement in the status reporting of capitation payments quarterly processing of registers to include progress of payment processing/delays.

Change:
HealthPAC will send, via email, nominated PHO contacts additional register processing status updates during the quarterly register processing cycle.
Ministry Reference: CBFS04 - 1.1B

2. PHO Monthly Manual Adjustment processing improvements
Improvements to the existing Manual Adjustment processes for Capitation Payments in the areas of documentation, reference, and audit.

Change:
Implementation of business process improvements (non-system) for PHO Manual Adjustments collection, coding and reporting.
Ministry Reference: CBFS05 - 1.1B

3. Decommissioning of the Capitation Information Cleansing (CIC) system
The CIC system was a temporary mechanism to clean PHO register data in order to meet the quality thresholds needed for register processing. This objective has now been achieved.

Change:
The CIC system will be archived and decommissioned. Any one-off Capitation register data cleansing outside of production register processing will be done through individual agreement between the PHO and HealthPAC.
Ministry Reference: CBFS12 - 1.2

4. DHB access to the PHO Datamart
Some DHBs do not presently have access to their PHO enrolment data for analytical purposes.

Change:
This project will record and address any identified DHB access issues to the PHO information Datamart and publish associated information on the new PHO Resources website.
Ministry Reference: CBFS20 - 1.3D

5. Revamped Ministry PHO resources website
A centralised source of useful, up to date information on capitation payment processes.

Change:
The existing PHO resources website is being revamped to improve the structure of and access to key information. New business processes to improve site content maintenance will also be implemented. The website will become the main channel for publishing new information packs on capitation payment processes.
Ministry Reference: CBFS26 - 1.3B

6. Publication of Information Packages on PHO resources website

6A. Ministry procedures on quarterly register processing status reporting
Information on status update points; how PHO recipients can be added/removed from the quarterly processing status updates list.
Ministry Reference: CBFS04 - 1.1B

6B. Ministry system implemented data validation rules
Information on the PHO-DHB contract business rules and implementation in the Capitation Based Funding (CBF) system; business rules for the key register data validation areas of:
  • NHI
  • HUHC
  • CSC
  • Geo-Coding
  • De-duplication

Ministry Reference: CBFS06 - 1.1B

6C. Processing error catalogue
Provision of adequate information on all error messages produced by the quarterly capitation and monthly payment processes to enable the identification and correction of the problem.
Ministry Reference: CBFS07 1.1B

6D. Quarterly reports descriptions and examples
Information developed and published on all Quarterly Reports / Extracts including content, availability, format, frequency and examples.
Ministry Reference: CBFS08 - 1.1B

6E. Monthly payment reports descriptions and examples
Develop and publish information on all monthly payment reports including content, availability, format, frequency and examples.
Ministry Reference: CBFS11 1.1B

6F. Ministry procedures for PMS Vendor HL7 message testing
There is no defined or documented process specifying what/if any test facilities are available for PHO and practice system vendors to test their system interfaces with HealthPAC.

Information will be provided on existing procedures for PHO and Practice Management System UAT support for PHO HL7 message changes
Ministry Reference: CBFS14 1.1B

6G. Ministry business procedures for manual adjustment processing
Develop and publish procedures for handling Manual Adjustment for Capitation Payments.
Ministry Reference: CBFS05 - 1.1B

15 March 2007

8. Ministry capitation key performance indicators (KPIs) agreed and initial measurements
KPI Reporting will enable pro-active management of end-to-end capitation payment processes to:
  • Ensure increased visibility and assurance that CBF processing is being completed successfully, and on time
  • Deliver early awareness of any important issues that need management attention or action
  • Monitor actual financial payments against financial forecasts to manage overall financial risk
  • Monitor the level of change activity occurring within these systems and processes
  • Assist in defining responsibilities and standards of performance.

Change:
The KPI process and content will be confirmed and initial measurements taken e.g. NHI data quality. Procedures will be established to report these on a regular basis to MOH management.
Ministry Reference: CBFS27 - 1.3A

30 March 2007

9. Ministry information technology support and infrastructure changes
Improvements to enable consistent and reliable quarterly processing.

Changes will include:
  • The development of effective reference and knowledge transfer documentation for personnel supporting quarterly CBF operations.
  • A process that ensures all personnel supporting quarterly CBF operations have received appropriate training, knowledge transfer and reviewed SOPs.
  • Improved monitoring processes for CBF quarterly processing (to work independently, though in conjunction with automated monitoring tools), including tests, checks and reconciliation at key points.
  • A process to transfer knowledge to other staff, including back-up staff, succession plans, and escalation procedures.

Ministry Reference: CBFS18 - 1.2

May 2007



15 May 2007

10. Ministry system and business process improvements for handling capitation rate changes
Implementation of a 'user entered rate table update' screen into Ministry Systems with an appropriate peer review and approval process. These changes must be implemented to production by 15 May 2007 ready for the next PHO rate table updates.
Ministry Reference: CBFS16 - 1.1A

11. Further automation of capitation systems and cessation of existing manual adjustments for Management Fees and Care Plus changes
Past reliance on the use of manual adjustment calculations and payments to urgently implement required functionality within capitation payment systems has increased risk and operational costs, and has reduced the quality of capitation audit and reporting.

Change: There are two existing policy changes that have not been implemented into the capitation payment systems. These changes will remove the temporary manual adjustment procedures that were put in place to calculate and pay:

1) Management Fee Policy Change:
Higher management fees to PHOs identified as having an enrolled population of up to 40,000 individuals.

2) Care Plus Policy Change:
Care Plus payments with additional threshold steps to provide more control around the distribution of Care Plus funding and more assurance that the funding is reflective of the uptake in PHOs.
These will be replaced with a full business solution that automatically perform these same functions. This payment will no longer appear as a manual adjustment on capitation financial reports.
Ministry Reference: CBFS09 - 1.1A

12.DHB and PHO Fee for Service Deductions report file name changed
The Capitation Fee For Service (FFS) Deduction Report produced each month uses the same file name and does not distinguish one report from the next nor the particular reporting period. This is causing problems in file administration.

Change:
The DHB and PHO Monthly FFS Deduction Report file name will be modified to include Month and Year generated.
Ministry Reference: CBFS10- 1.1A

13. Ministry NHI Anomalies measurement and analysis
Disparities exist in the NHI data held between Primary Care Practices, PHOs and the NHI, which means patients are unable to be assigned, correctly identified or have correct status recorded.

Specific problems are in the areas of:
  • Duplicate, deceased and merged records.
  • Spurious Data - patients do not exist or demographic data is incorrect hence they can never be accurately matched.
  • Inflexible Matching Logic - where some patients can not get assigned NHIs.
  • Lack of regular monitoring and visibility - no regular data quality measures against the NHI data assigned to PHO registers means there has been no early visibility of potential problems.

Change:
Setting up data quality measures and agreeing the solutions needed for implementation in the next phase.
Ministry Reference: CBFS21 1.3D

July 2007



1 July 2007

14. PHO Buyer Created Tax Invoice (BCTI) and DHB Financial Report changes Improvements in the information provided in financial reports to DHBs to better support reconciliation, validation and approval processes.

Change:
Changes include fee codes to the following to enable improved reconciliation:
  • PHO BCTI
  • DHB Financial Extract

Changes will be implemented ready for 1 July 2007 (financial year start) to achieve the most benefit.
Ministry Reference: 1.1A - CBFS11

15. Policy Change - PHO revised capitation rates (25-44s)
Policy Change to increase capitation payment rates for the 25-44 age group and Future Funding Track (FFT) increase.

Change:
Changes to the dollar values paid in the standard CBF rate table.
Ministry Reference: CBFS09 - PMO266 - (PMO94) - 1.1A

NOTE: Apart from project 6F, the Capitation HL7 Electronic Message is not affected by these projects.


23 July 2007

16. Monthly updates to Geostan reference data
CD updates for Geostan reference data have previously been posted out quarterly to approved Geostan users. This frequency has now been increased to monthly to ensure the latest data is provided for geocoding.

Change:
Critchlow Ltd (or a subcontractor) will send monthly CD updates for the Geostan application via post, with the first monthly update to be sent at the end of July.

September 2007



September 2007

17. MSD - Super Gold Card - CSC endorsement changes

SGC External Comms (MSD) v1.3 (Word, 120 KB)

SGC HealthPAC Fact Sheet v3 (PDF, 95 KB)

18. Capitation Enrolment and Register Handling Guidelines - Train the Trainer (PHO)

Train the Trainer sessions start in September and finish in October (timetable has been distributed)


January 2008



19. Under Sixes Changes

More support for free doc's visits for under-6s (www.beehive.govt.nz)


March 2008



1 March 2008

20. CBF Quarterly Reports Changes

CBF Quarterly Reports Workshop Results (Word, 111 KB)
Capitation Summary Report for DHB (Excel, 122 KB)
Capitation Summary Report for Organisation (Excel, 146 KB)
Changes for Quarterly Reports (Word, 122 KB)

    2007/2008 Change Calendar in Word format


    A printable version of this calendar is now available in Word format

    2007/2008 Change Calendar (Word, 370 KB)


    Page last updated: September 2007


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