‘Keep calm and take action’ over ACFI budget measures, providers advised
An aged care funding specialist has called for residential providers to avoid panic and instead take immediate action to lessen the impact of the Federal Government’s proposed changes to reduce future spending.
An aged care funding specialist has called for residential providers to avoid panic and instead take immediate action to lessen the impact of the Federal Government’s proposed changes to reduce future spending.
As announced in this month’s Federal Budget, the government intends to make further changes to the Aged Care Funding Instrument (ACFI) scoring matrix largely within the Complex Health Care domain affecting areas such as the management of pain, arthritic joints and medications, to save $1.2 billion over the next four years.
The aged care sector believes the impact of the proposed changes is more far-reaching than predicted with peaks Leading Age Services Australia commissioning analysis from Ansell Strategic and the Aged Care Guild seeking a report from Deloitte to highlight the financial impact on providers and subsequent impacts to residents.
Notwithstanding the potential significant financial loss, the general response in the industry has lacked solutions, which is feeding into panic, said Jacqui Banham, ACFI and clinical services director at Provider Assist, which offers income, support and management solutions across the aged care industry.
“Our mantra through all of this is to keep calm and take action,” Ms Banham told Australian Ageing Agenda.
That action starts with understanding the situation of an individual facility, rather than taking an unnecessarily reactive and immediate response to “tighten the belt,” she said.
“Let’s draw breath, look at what you can do and let’s move into the new world – albeit none of us like the new world – but be in the better position so the residents at the end of the day aren’t going to be the ones that are suffering.”
She said the proposed changes were unreasonable and driven largely by an incorrect premise of unethical claiming.
“I am sure that there have been providers that have perhaps not been as ethical in their claiming profile, but I honestly believe the bulk of the industry is understanding chronic pain and really doing some amazing things with pain clinics and all sorts of things that enable that to happen,” Ms Banham said.
However, she said the scenarios were based on common claiming profiles but the actual impact would be personalised according to an individual facility’s situation and that is where providers should start.
“Get a real perspective and start to do some of the analysis in your organisation because a number of providers may find … this may not be impacting them very much at all,” Ms Banham said.
She said other action providers should take to put themselves in the best position possible include processing any backlog of voluntary appraisals, and ensuring comprehensive assessments were thorough and claiming profiles correct.
Ms Banham said according to Provider Assist’s data, which is based on about 85,000 beds nationally, 70 – 80 per cent of providers were under claiming, particularly in the area of activities of daily living, where assessments were often based on what the carer said they were doing rather than assessing the whole of a resident’s care needs.
Action areas
While the 1 July changes would have an impact it was not as significant as the potential “crippling” 1 January 2017 changes, Ms Banham said.
“I see a lot of facilities perhaps reducing physio hours, not having their treatment nurses or maybe disbanding their pain clinics for new residents,” Ms Banham said.
Firstly, she said providers should look at their claiming profiles in a given facility taking length of stay into consideration and then make a predicted call on what the financial impact would look like before making any decisions.
The next area to address was voluntary reappraisals, which often built up because of workflow and no mandatory response required, Ms Banham said.
“Our advice to the industry right now is they have a seven month window in which they should be focusing on all those people sitting in their voluntary pool and actually reappraising them before January 1,” Ms Banham said.
Doing that puts providers into a much better and more accurate position and doing it well minimises the chances of residents then changing from a voluntary base, she said.
When someone admits to aged care from an acute setting they automatically flag a mandatory reappraisal after six months, while everyone else is under voluntary appraisal following their initial assessment meaning their ACFI can remain unchanged for as long as they are there, Ms Banham explained.
Finally, she advised providers to look at admissions coming in and mandatory appraisals to ensure they were being comprehensively assessed and the correct profile was claimed.
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I agree with Jacqui, take a look at the resident’s care needs and profile.
Unfortunately there are providers who have instantly looked at their bottom line, without looking at how to reduce the impact of the changes, and reduced staff and care provided.
The answer is simple – introduce CDC into your residential care operations and manage the contributions from both government and residents. In the end you can only provide services that are funded and the only way to do this is to have a system that is an open and honest assessment of income and costs and the services that can be provided for the amount received, as is the current and new world of Home Care.
Try and do it the old way and you are bound to fail.
Just a suggestion.
Taking action began years ago… to everyone’s detriment
When ACFI started, complex health care was provided by registered nurses. Now it’s done by low-paid carers, but all the while funding for CHC continued to increase.
Providers have set the scene themselves for a justification that CHC funding should be cut – because CHC has been, and continues to be, provided much more cheaply than was ever intended.
Perhaps you should be diverting some of your 40% increase in annual profits (Bentley report) by re-investing in qualified nurses and providing the quality of care that the funding (and your residents) anticipated.
Just a thinly veiled plug for business. If 70 – 80% of providers are under claiming, no doubt you’ll be able to ‘advise’ them right up until the next funding cuts occur as a result of sharp claiming practices.
These ACFI maximisers have been a large part of the problem.
Simply regurgitating basic ACFI business rules and asking everyone to breathe doesn’t constitute professional advice. Stating that the industry understands chronic pain while it persists with passive, non evidenced-based 4a &4b treatments shows just how little it’s really understood.
Alan’s right, play by the rules and spend the money on it’s intended target.