Provision of Health Services Across Provincial Jurisdictions: An Analysis of Costs vs Inter-Provincial Billing Rates

Presenters

  • Denise Arsenault, VP Finance & Chief Financial Officer, The Hospital for Sick Children, Toronto, ON.
  • Irene Blais, Director Decision Support, The Hospital for Sick Children, Toronto, ON.
  • Chair:  Allan Horsburgh, Vice President of Operations and Support Services and Chief Financial Officer, IWK Health Centre, Halifax, NS

Synopsis

The interprovincial hospital billing agreements are intended to provide coverage of medically necessary insured health services for eligible patients of provincial/territorial health insurance plans.  Hospital services provided to out-of-province patients must be billed in accordance with the interprovincial hospital billing agreements.  For tertiary hospitals, many of the interprovincial activity is focused on more complex and higher cost patients requiring care due to proximity and/or lack of specialty services geographically.

Using its case costing system, SickKids has been analyzing both the costs and associated billing rates for patients (both inpatient and outpatient) over the last 2 years and a number of areas of concern have emerged from this analysis.  SickKids will share its analysis and findings with CAPHC peers in order to enhance understanding of current interprovincial billing limitations with others.  This will provide the basis for a discussion to determine whether any next steps are warranted from a CAPHC collective with the Interprovincial Health Insurance Agreements Coordinating Committee (IHIACC).

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Provision of Health Services Across Provincial Jurisdictions: An Analysis of Costs vs Inter-Provincial Billing Rates