Using Case Costing Data and Case Mix for Funding and Benchmarking in Rehabilitation Hospitals

The concern for Ontario hospitals in Canada is that the funding model has recently changed from global- to activity-based funding, which will affect hospitals' operational budget and cost management. Hospitals will be reimbursed based on a pre-set payment price for each patient type or case mix treated. Specifically, the purpose of this chapter is to describe how case costing data and case mix information are collected and used for funding. A framework is proposed for health administrators, policy makers, and researchers to understand the input variables for determining resource utilization and long stay trim point. A clinical decision-making tool is demonstrated to assist hospital administrators to define admission criteria and predict length of stay and volumes with clinical teams. The chapter highlights the importance of data quality and use of comparative data and concludes with 10 key success factors for better funding and benchmarking for rehabilitation hospitals.