2013-2014 Budget Consultation

1. 2013-2014 Budget Consultation

2. Why is change happening now? PROVINCIAL fINANCE

3. Ontario – Surplus/Deficit History

4. 2012 Ontario Budget

5. 2012 Ontario Budget • “Total hospital operating funding is the largest area of health spending and has increased by an average of 5.1 per cent annually since 2003” • “This Budget will help maintain excellent health care for Ontarians while slowing the overall growth in health spending in Ontario to an average of 2.1 per cent annually, over the next three years.”

6. Health System Funding Reform

7. Health System Funding Reform Cont’d Health Based Allocation Model (HBAM) Formula driven - Price X Volume Based upon population characteristics Evidence-based activity Funding rates informed by best practice Provides 40% of MAHC Funding Acute and Day Surgery Emergency Department Complex Continuing Care

8. Quality Based Procedures Hospital funding is reduced at the hospital’s average cost per procedure/weighted case The hospital then receives new funding at the 40th percentile cost of performing the procedure This will account for approximately 30% of MAHC Funding by 14/15 Health System Funding Reform Cont’d

9. Health System Funding Reform Cont’d Quality Based Procedures Funding Excluding bi-lateral procedures/funding

10. Health System Funding Reform Cont’d

11. Closing the Funding Gap Proposed solutions for 2013/14

12. Planning and Decision Guides Rural and Northern Healthcare Report (2010) • 90% of residents in a community or local hub will receive specialty inpatient hospital and tertiary diagnostic services within four hours travel time from their place of residence. • 90% of residents in a community or local hub will receive emergency services (24/7/52) within 30 minutes travel time from their place of residence • 90% of residents in a community or local hub will receive basic inpatient hospital services within one hour travel time from their place of residence

13. Planning and Decision Guides Cont’d 2012 Ontario Budget • “The [funding reform] model will drive provincial health care funding towards better patient outcomes by: • directing funding to efficient providers who provide better or more efficient services or treatments; and • improving quality through specialization.”

14. 2013/14 Budget * MOH/LHIN funding is unknown at this time, but is expected to decrease from 2012/13. $150k reduction in revenue is revenue from all other sources.

15. Proposed Solutions for 2013/14 Funding Reform is shifting funding to community providers, so some patients previously cared for in the hospital will now receive care outside the hospital Acute Care Bed Reductions • we can continue to service the same volumes with the same quality care with planning and process transformation Complex Continuing Care • Single siting Complex Continuing Care allows efficient utilization of staff and resources

16. Proposed Solutions for 2013/14 Cont’d Integrated Stroke Rehab Beds • there is a high need for Acute Stroke Rehab Beds in Muskoka • HDMH has been identified as a stroke unit site • MAHC is working to establish a ten bed unit to serve the population of Muskoka

17. Proposed Solutions for 2013/14 Cont’d Bed Reductions

18. Proposed Solutions for 2013/14 Cont’d Single Siting Services • It is believed that single siting services and combining the volumes will enhance clinical competency, patient outcomes and improve the operating position of MAHC • Ophthalmology • Chemotherapy (day clinic)

19. Programs & Services Across MAHC

20. Proposed Solutions for 2013/14 Cont’d • The proposed budget solutions are not about reducing or cutting services, they are: • intended to find a more efficient way of providing and preserving these services in our communities; • creating capacity for other services; • MAHC must balance the level of those services within defined fiscal resources

21. Questions? Thank you!