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Consulting & Engineering
IMC CONSULTING – MODULES
> Health system planning - MODULE HP
> Health financing system - MODULE HF
> Feasibility studies - MODULE FS
> Task force - MODULE TF
Module HP Health System planning - simplified approach
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Step 1: Consensus on benchmark as to bed-/population-ratio & future bed needs
Step 2: Consensus on minimum department size / number of beds (per speciality)
Step 3: Natural catchment areas of current hospitals (GIS & traffic network model)
Step 4: Decision on hospitals / departments to be converted (accessibility !)
Step 5: Simulation model - scenarios using GIS & traffic network model (iterative)
Step 6: Comparison of bed needs by hospital & speciality, derived
Step 7: Considering medical synergies in each hospital (specialities & equipment)
Step 8: Recommendations on locations of hospitals, departments, beds, …
Step 9: Cooperation of hospitals and other health & social care institutions (PHC)
Step 9: Political decision process on HCMP recommendations
Step 10: Implementation of HCMP (investments, converting hospitals, ...)
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| Module HF: Health financing system – DRG -based |
| The aim is to implement a procedure oriented hospital financing system based on the successful Austrian LKF model. This results of study could be used in formulating and integrating a National Health Policy where financing is an integral component. |
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Role / importance of DRG systems |
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Diagnosis related groups (DRG) are tailored to the data structure used for the documentation of hospital treatment in a given health system. Based on actual resource use episodes of hospital treatment are pooled and, using statistical methods, grouped into groups of comparable resource utilization. Once these groups are determined and accepted the groups can be used for the reimbursement of hospitals thus reflecting their productivity. The results can also be used for bench-marking purposes between hospitals or departments as well as for the documentation of presumed epidemiological trends. |
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Diagnosis related groups have been developed over the last thirty years starting from the United States. Meanwhile most developed health systems have embarked on the development and use of diagnosis related groups for steering and financing their hospital sector, which is the single biggest sector in all health systems in terms of resource use. Several accession countries to the European Union and some Asian countries have started the development of their own diagnosis related groups since. In conclusion it can be stated that the use of diagnosis related groups can be considered a modern standard for the management of the hospital sector in most health systems. |
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The implementation of this modern diagnosis and procedure related hospital financing system for hospitals will result in important developments that would assist, guide and provide the healthcare planners the tools for formulating and organizing the changes to the healthcare services. It raises the financing system to an international standard and enables healthcare planners to make decisions based on sound data. The Austrian model (LKF) is proposed because of its successful implementation and proven track record over the period of 10 years. |
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The LKF is a performance oriented financing of hospitals with the objective of:
> Reimbursing hospitals in an efficient manner.
> Enabling cost transparency and efficient decision making.
> Maintaining high standards of care.
> Reducing duplication and unnecessary processes in the provision of services.
> Formulating long-term cost containment.
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To obtain the LDF-groups a tree algorithm is established to capture medical, economical and statistical criteria for a preliminary, representative sample of patients. Based on these data the LDF-groups (DRG) are built. They are portioned into 2 main categories according to services (procedures) and main diagnostic categories. |
The costing of LKF is based on agreed critical/clinical pathway guidelines, which are developed by healthcare professionals.
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Module FS: FEASIBILITY STUDIES
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Healthcare
Service Metrics
Bed Capacity
Utilization %
Utilization No.
In-Patient
Junior suite
Royal suite
Out-Patient
ICU days
Prenatal packages
Deliveries
Caesarian sections
Paediatrics OPD consultations
MRI
Laboratory
Usound/Xray |
Operating Revenue
Single bed
Junior suite
Royal suite
Out-Patient
ICU
Prenatal
Delivery
Caesarian
Paediatrics OPD
MRI
Laboratory
Usound/Xray
Pharmaceuticals
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Total Gross Revenue
Operating Expenses
Pre operation expense
Salaries & Benefits
Supplies & Disposables
Administration & Support
Marketing & Care Services
Provision for Bad Debt
Working capital
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Total Cost of Services
Gross Operating Profit
Depreciation
Interest Accrued
Net Profit
Debt Retired
Net Cash Flow
Cummul. Net Cash Flow
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MODULE TF: TASK FORCE
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Market Analysis:
>Preliminary Demand forecast
>Site visits
>Medical & Non medical Department definition
>Room program and space requirements
>Homecare service concept
>Listing of all related assumptions
Costs assumption + prel. Layout
>Financing methods and cost of capital
>IMC Matrix – definition of local and international scope of services
>Construction costs
>Medical equipment costs
>Non medical equipment costs
>Mechanical and electrical systems technology costs
>Projected fees (e.g. planning, architectural, engineering etc.)
>Architectural layout scheme 1:500
Contract drafts:
>Financing securities
>Turnkey contract draft, solely obliged IMC/partners to establish and execute the project
>Bankable Letter of Intent (LOI) financing for 100% financing of the Turnkey contract volume
>Finance contract draft
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