How does my local foundation trust calculate prices for patient care?
As CCGs start to take on their statutory duties, many GPs will wonder how their local trust calculates the prices that they charge for patient care
Some prices are mandated by the Department of Health under the payment by results tariff regime, but others fall under local pricing arrangements and these can vary considerably around the country.
In the past, it was quite hard for commissioners to substantiate whether the prices they were being charged under these arrangements were reasonable, but not anymore.
The DH, in conjunction with the Healthcare Finance Managers Association (HFMA), has come up with a new approach that attempts to grade exactly how good individual trusts are at ‘costing' – and hence ‘pricing' – their activity.
The materiality and quality score (MAQS) is an objective assessment, stated as a percentage, of your local trust's ability at costing. The levels of competence are set at gold (100%), silver (75%), bronze (50%) and baseline (25%). In fact, the DH is so keen on MAQS that there is already talk of it using a cohort of the highest-scoring trusts to set the payment by results tariff in future, rather than using reference costs as is the case now.
A trust's MAQS, therefore, gives GPs a strong indication of its underlying efficiency and also its ability to cost its activity correctly. To find out how your local trust scores, contact the director of finance at your local trust in the first instance and then they will be able to point you in the right direction.
James Wilson is the director of Assista Consulting UK