Civica Health & Social Care

Transcription

1 Civica Health & Social Care Focus on > SLAM for Healthcare Providers Improved communications with commissioners, leading to clarity and better relationships

2 Civica Focus on> The solution SLAM is the ideal solution for processing local commissioning data and reconciling it to the commissioner s version. As soon as your local data is available you can quality assure it for commissioning, and run your own version of claims validation to give yourselves valuable early insights into commissioning issues. This will give you more time to ensure your income is secure. Once SUS data is available, SLAM will automatically process the data in readiness for delivery to commissioners. It will also identify any differences between local and national data, down to individual patient episode. These reports are invaluable timesavers in resolving data quality and consistency issues. Products SLAM - Be in control of your income Overview Provider Trusts are under increasing pressure from commissioners to deliver accurate management reports and validate all claims/invoices early in the monthly reporting cycle. By the time SUS data is validated and processed, there is little time left for discussion as the freeze date is looming. Civica s Service Level Agreement Manager (SLAM) allows providers to begin the process early by using local data, up to 3-4 weeks before commissioner data is made available. SLAM also ensures that local and national datasets are fully reconciled to give one version of the truth. Civica provides the tools to support this process of early reporting and gives you an early insight into likely disputes with your commissioners, whilst minimising the manual work required preparing complex, high volumes of data. Civica s SLAM integrated commissioning solution (ICS) is built around the core SLAM commissioning application which has been successfully delivering to over 200 NHS organisations for a decade. The core SLAM application is the most widely used solution of its kind, deployed across half of the NHS, processing in excess of 35 billion of NHS funding each year. SLAM ICS further enhances SLAM by delivering advanced and user friendly reconciliation, validation and analytical functionality. Going that one step further, SLAM allows clinical support organisations, clinical commissioning groups, GPs and provider trusts to communicate via a commissioning reporting portal. This offers direct access to financial reports and performance dashboards via your standard web browser. Core SLAM Core SLAM processes, monitors and manages activity and pricing, using PbR, non-pbr and block contracts. SLAM SUS analyser The analyser extends SLAM to import and process national SUS data (SEM & PbR mart), and supports the reconciliation of local and national data. SLAM claims validation Ensures that claims (invoices) which should be queried or refused are identified and issues resolved with minimal effort. Claims validation works for both local and national data and therefore can produce reports very early in the monthly commissioning process. Providers can use the system to simulate the commissioning process and get early views of and queries, issues or concerns. SLAM s online reporting portal Allows directors, service managers, consultants and other clinical staff secure access to SLAM data directly via the web. A comments facility integrated within the portal infrastructure allows all parties to communicate with one another during the commissioning process. include high income/high volume patients, XBD above trim point, highest specialty variance, highest POD variance, PCT/Cluster variance, practice variance etc. You can also add comments to any report for further review by your team or others. SLAM workflow Saves income managers and information staff hours or days chasing and responding to spread sheets and s from commissioners. You can use workflow to communicate information on claims validation queries, trend changes, outliers and general enquiries. SLAM model master Is a strategic planning module which creates activity and spends forecasting. Models are based on multiple assumptions including demographics, market share, changes in medical care, technology advances etc. It is ideal for quick analysis of contract variations and their long-term effects. 02 SLAM offering integrated commissioning support 03

3 Functional overview The features of Civica s SLAM Week > Review of potential claims queries prior to submission. > You see what the commissioner sees, but sooner. > No additional work - all 226 SUS data processing steps are automated. > Full reconciliation to national and commissioner views. Data from SUS > SLAM takes the early SUS file available to providers 1-2 days after submission and runs a full commissioning process on it within hours. > More accurate and consistent data and reports. Local Data Comprehensive Validation SLAM Fully Reconciled PbR team, Finance, Information, Service line reporting Plan vs Actual & Claims Validation SUS Reconciliation By: Sector PCT Cluster Sub-cluster Practice By: Sector PCT Cluster Provider The benefits of Civica s SLAM > Improved communications between commissioners and providers, leading to clarity and better relationships between them. > Time required to validate and prepare both local and national (SUS) data is dramatically reduced. > Provides a better service by allowing your analysts to spend more time analysing and advising whilst reducing time on data preparation. > Confidence in the reports provided to your clients will increase. > Offers a comprehensive view; SLAM supports all commissioned activity e.g. PbR, non-pbr (local tariffs & agreements) and block. > SLAM is a proven and trusted low risk solution with over 10 years service and 200 NHS organisations validating its integrity every year. > Up to 80% fewer commissioner queries to process. 04 SLAM offering integrated commissioning support 05

4 Correlation to NHS reconciliation guidance Why Civica? The solution proposed meets all of the national guidance requirements. Key extracts are identified below. Guidance NHS guidance recommends routine reconciliation between local & national data. There is an understanding of the use of local data to allow the monthly process time to operate effectively. Any system of reporting for commissioning must have the ability to track back to the relevant patient data. Civica delivery SLAM SUS Analyser will deliver all reports required for data reconciliation. SLAM reports offer drill-down to patient data, where security considerations allow. Civica is the leading supplier of commissioning management solutions to the NHS with a proven track record and large market share. We work with health service providers and commissioners and their partners to deliver solutions that streamline the management of health and social care and improve patient services. The Group supplies more than 250 NHS organisations in the UK including two thirds of Foundation Trusts, 80% of Acute Trusts and more than half of the current PCTs, together with some of the leading health services in Canada. At Civica, we... > Provide systems that handle 40bn of NHS funds, 27m theatre appointments annually, and 7m pathology records, performing 35m calculations every minute. > Work at all levels within UK Healthcare. > Have a clear understanding of the complex financial flows across the NHS. > Can help you manage, with specialist systems and business process services including workflow and EDM, records management, mobile working, and cloud computing, all with extensive and comprehensive support. Civica is a UK company, with people who understand your organisation and business processes in order to help you achieve your objectives. Reconciliation processes should be both top-down and bottom-up. Reconciliation should be against activity, currencies and priced currencies. SUS-PbR is promoted as the preferred commissioning dataset, although use of SUS-SEM is accepted as necessary. Local processing of PbR is complex and cannot be guaranteed to be free from error. There are concerns over the use of locally developed software leading to inconsistencies in data and possibly in payments. SLAM reconciliation reports provide aggregated reports at multiple levels, e.g. provider, HRG, various patient groupings. They also provide detail at patient level. SLAM compares SUS & local activity at patient level, alongside currencies and their correct application. Civica is expert in this area, providing invoice algorithms to around 190 MHS organisations. SLAM works with both SUS-PbR & SUS-SEM, as well as with local datasets. SLAM is continually updated in line with guidance and user needs. We have been supporting PbR successfully since its inception in 2003 and now process in excess of 35Bn of NHS funds. We have a reputation for providing practical solutions and clear, consistent, auditable information for the commissioning process. GP practices are demanding more accurate pricing information earlier. We have chosen Civica as our new partner based on their ability to bring a combination of technology, people and business processes as well as expertise in local NHS trusts and the market to move forward with improved management and control of commissioning. Paul Birch, Head of Contracting & Business Intelligence, NHS Milton Keynes and Northamptonshire commissioning support hub 06 SLAM offering integrated commissioning support 07

5 For more information please visit us at /health-and-social-care Or contact us on or London 2 Burston Road London SW15 6AR Tel: +44 (0) Altrincham Station House Stamford New Road Altrincham WA14 1EP Tel +44 (0) Copyright Civica Group Limited All rights reserved. Product names referenced in this document may be trademarks or registered trademarks of their respective companies and are hereby acknowledged. Civica is an international market leader in specialist systems and business process services for the public sector. Through experienced people who understand service delivery we apply software, managed services and outsourcing to help our customers streamline their activities and achieve a successful and more cost-efficient way of working.