Primary Health Care

Capitation Payment Information Project

Background
Project Objectives
Fast Track Improvement Projects

Background

Better systems, better information, leading to better health is the ultimate goal of the Ministry of Health initiative - Improving Health: Payment Systems, Information & Connectivity (the National Systems Development Programme). Comprising six workstreams, this programme aims to deliver significant benefits through improved systems that will interact more effectively within the wider health and disability sector.

The Improving: Capitation Payments and Information workstream focuses on the capitation funding environment - a network of primary care practice, PHO and HealthPAC computer systems and business processes.

Between October 2005 and April 2006, the Ministry consulted with representatives from DHBs, PHOs, Management Service Organisations (MSOs) and General Practice to identify opportunities for improvement in this capitation payment environment.

As a result of this collaboration, a programme of improvements has now been identified to improve stakeholder financial control, sector efficiency and capitation system effectiveness.

Project Objectives

The Capitation Payments and Information workstream therefore has the following objectives:

Improve financial control - enable better fulfilment of allocation, disbursement, and utilisation accountabilities.
Improve sector efficiency - reduce errors and duplication of effort resulting from work-arounds, manual processes, and patch fixes.
Improve capitation system effectiveness - improve capitation systems and processes to ensure they are stable, accurate, and timely.

While the workstream will benefit all primary care stakeholders, the key benefits for PHOs and Practices will include:

More reliable capitation payment processing
Improved, simplified invoices
New and improved reports including easy to reconcile capitation and fee-for-service payment reports, including adjustments
More accurate and easier to obtain patient National Health Index numbers (NHIs)
Simplified, consistent business processes
New payment processing status reports
Information resources and training support for PHO and Practice staff
Improved access to HealthPAC support staff.

Fast Track Improvement Projects

Within the workstream, a number of fast track improvement projects (Word, 106 KB) have been identified; these have a focus on data and process improvements and are scheduled for completion by mid 2007.

These projects include the resolution of NHI data anomalies, business process improvements, new processing status reports, new sector communication mechanisms, testing support for practice management systems, and new payment processing key performance indicators (KPIs).

Subsequent projects will focus on improved reporting and system changes.

Page last updated: January 2007