Developing a Framework for Case Costing in Long Term Care in Ontario

Bruyère Continuing Care, University Health Network, University of Ottawa (ON)


The Challenge

The health care system's cost continue to grow faster than the provincial budgets ability to absorb, while the demands on the system from patient/residents, especially by the aging population, are on the rise. It is imperative that health care sectors get accurate cost information to make informed decisions. This challenge is even more accurately felt in the LTC sector which has been chronically underfunded. It is imperative that the LTC sector gets a better handle on it resource utilization to better allocate costs.

The Improvement Project

Currently in Ontario, LTC is funded through a historical hybrid funding model combining envelope funding and co-payments by residents. Only as of January 1, 2013 has the Ontario government allowed for increased flexibility of funding and usage between envelopes. Even still, the current funding and allocation model does not provide any clarity on the average costs per case and where/how funding is being spent. The MOHLTC has provided a framework for rolling out a standardized case costing system in acute care, complex continuing care, rehabilitation, select areas of ambulatory care and CCACs. Thus, the aim of the fellowship would be to replicate this methodology for Ontario LTC homes in a way that makes the most sense. Case costing is a way to improve resource allocation by providing accurate information on resource utilization and educating leadership on the results so that the information can be used to make sound financial decisions. This would be accomplished by providing a toolkit for LTC Homes to use in rolling out a case costing model.