IAPT Payment by Results Project Update

Relieving distress, transforming lives

IAPT Payment by ResultsProject Update

David PertonIAPT PbR Project Manager

Department of Health


What the Presentation will Cover • The Currency Model

• The Data Being Collected

• The Analysis Reporting Timescales

• The Project Plan

• The Analysis to be Undertaken

• What is Outside the Scope of the Feasibility Study


The Draft Outcomes Based Currency Model

• The five outcome areas are:1. Equity of Access (15% from 6 measures)

2. Clinical Outcomes & Recovery (50%)

3. Reduced Disability WSAS (10%)

4. Employment Outcomes (10%)

5. Patient Satisfaction and Choice (15%)• These outcome areas represent NICE indicated quality

standards Evidence Based Practice (EBP) together with IAPT quality standards Practice Based Evidence (PBE) from the analysis of Year one data (see Gyani et al report)


Data Being Gathered from 22 Pilot Sites

• Patient level activity, outcomes & experience data

• Demographic & SLA data, to support the Access Domain (by 28th September from commissioners)

• Fully absorbed cost breakdown by contact and type of intervention (completed 12th October)

• A sample of Mental Health PbR Care Clusters (end October?)


Patient Level Data Monthly Submissions

• IAPT Minimum Data Set (MDS) (50 items) flowed to the Information Centre under the ISB notice.

• IAPT Additional PbR Dataset (33 items, e.g. PEQ scores) also flowed to the Information Centre using the same process as the MDS


One Off Data Collection from Pilot Sites

• Cost Data– Fully absorbed (i.e. direct, indirect & overheads)– High & Low Intensity– Intensity Mapped to Therapy Type and Staff Role– Hourly Costs

• Demographic Prevalence Data– Over 65s– BME

• SLA Volume (by Intensity of Therapy)• Mental Health PbR Care Clusters


Analysis Plan: Two Stages

• Stage 1– Based on first 5 month’s data– Informs a discussion paper published mid-December– Informs initial findings (including 2013/14 recommendation)

published February 2012 with Final MH PbR Guidance

• Stage 2– Based on all 9-month’s data– Informs final findings published April 2013


Project PlanIAPT PbR Milestone Plan (11/06/2012)

Apr-12

May-12

Jun-12

Jul-12

Aug-12

Sep-12

Oct-12

Nov-12

Dec-12

Jan-13

Feb-13

Mar-13

Collect & submit patient level data from pilots sites Collect & submit sample MH cluster & resource usage from pilots Define cost collection methodology

Collect costs

Collect demographic data

Scope analysis & modelling

Tendering process

Accept Tender

♦

Data Preparation & Statistical Analysis

Issue Discussion Paper

♦

Issue 2013/14 guidance ♦Further Data Preparation and Statistical Analysis

Compile Final Report

Handover to Mainstream PbR Team


Deliverables of the Analysis1. Analysis of Cost Recovery

2. Analysis of the Feasibility of Data Collection

3. Analysis of the Affordability

4. Service User Analysis

5. Lessons Learned Analysis

6. MH Cluster & Cost Analysis

7. Demographic Profile

8. Usage Profile

9. Case-mix Profile

10. Referral, Satisfaction, Choice & Outcomes Profile

11. Work & Social Adjustment Scale (WSAS) Analysis


Cost Recovery• Analysis Matrix

– Percentage of currency by month & by provider

• Measures– Variance between providers– Variance between commissioners– Variance between months (Stability/volatility)– Do services performing well recover costs– Are services performing poorly incentivised to

improve– Are there any perverse incentives


Feasibility of Data Collection

• Measures of Data Quality from Information Centre

• Measures of Data Completeness

• Analysis of Lessons Logs from Providers

Affordability

• Compare PbR Payments to Block Contracts


Service Users

• Not Paid For (less than two sessions)

• Two Sessions Only

• No Clinical Improvement or Deterioration

• Data Completeness of Patient Experience Questionnaires

• Lessons Learned


Lesson Learned

• Any Other Lessons from Commissioners & Providers

Mental Health Clusters

• Correlation Between Cluster and IAPT Episode Cost?


Demographic Profile

• The proportion of the service users that are of working age• The proportion that are in the vulnerable age (16-24) in

terms of employment outcomes?• The proportion of aged 65 and over• The proportion of each ethnicity• The proportion by gender• An Analysis of if any group above is under-represented


Usage Profile

• The average number of therapy sessions patients have

• The proportions of High Intensity and Low Intensity therapy sessions

Case-Mix Profile

• By Mental Health Clusters


Referral, Satisfaction, Choice & Outcomes Profile• Proportion of patients treated that were below caseness when

assessed• Proportion of disabled patients treated that were below caseness

when assessed• Proportion of self-referred patients treated that were below caseness

when assessed• Proportions of self-referrals, by age, ethnicity, gender and disability• Correlation between referral mode and satisfaction • Proportion of patients with a preference for treatment option • Correlation between clinical improvement/recovery and satisfaction • Correlation between clinical improvement/recovery and choice • Correlation between clinical improvement/recovery and diagnosis


Work & Social Adjustment Scale (WSAS)

• Disability (initial mean WSAS)

• Clinical Outcomes (change in mean WSAS)

• Cost of the Patient Episode (change in mean WSAS)


Not part of the scope of the Project at this stage:

• Price & Cost• Unbundling• Incentivising Quality & Outcomes, Beyond Goals• What-if Analysis

– Sensitivity Analysis• Changes to elements within domains• Changes to proportions assigned to each domain

– Iterative optimisation

Maybe Required if a National Tariff is to be Developed

http://www.iapt.nhs.uk/pbr

Date post:	31-Dec-2015
Category:	Documents
Upload:	teegan-thornton
View:	32 times
Download:	0 times

IAPT Payment by Results Project Update

Documents