Maternity pathway payment system in 2012-13 updated
The background information on how and why the PbR maternity pathway system has been developed is published.
Applies to England
Documents
Details
This includes the structure of the system, how prices have been produced, data templates, business rules and frequently asked questions.
Please note that much of this data was originally posted on 16 February, 2012. We would like to highlight the attached files, which have been updated due to changes in the data definitions and requirements.
Details of the amendments to the data definitions and requirements can be found from our road test 2013-14 update.
Below is an explanation of the documents that make up the payment system:
Pathway system slides
The pathway system slides summarise the context for bringing in the new payment system for maternity care in shadow form. It contains simple templates for the information required (antenatal and postnatal) to run the system and provides the shadow prices for 2012-13.
Business rules
The document, 2012-13 business rules contains the business rules and some questions and answers that commissioners and providers should use in commissioning maternity care.
Technical calculations
The technical calculations spreadsheet provides the technical data and the calculations used in developing the prices for each part of the system. Developing prices using the technical calculations spreadsheet document explains the methodology used to develop prices and should be used in conjunction with the spreadsheet.
Shadow year for maternity pathway pricing and template
The shadow year for maternity pathway pricing explains the rationale for the shadow year and why each maternity provider and commissioner need to implement this new system in shadow form during 2012-13.
A shadow year template is provided that may aid organisations to summarise and understand their case mix for each part of the pathway, compare their case mix with the national averages, translate their expected case mix into planned income, and evaluate the financial impact of this new system.
Antenatal pathway
The antenatal pathway document describes the specific characteristics and factors, based on the health and social care assessment undertaken at the booking appointment, that allocate women into a specific antenatal payment category based on expected resource use.
Postnatal pathway
Postnatal pathway describes the specific characteristics and factors, based on information gathered throughout the antenatal and birth periods, that allocate women into a specific postnatal payment category based on expected resource use.
Antenatal and postnatal simple data collection forms
The antenatal and postnatal input proformas are simple data collection forms for electronically recording each woman’s antenatal and postnatal data locally; it produces the relevant HRG for each woman, and appends each data record, in much the same way as a grouper on the data bank sheet.
Alternatively, organisations may wish to develop their own local system, or adapt these further for their own use, or for use across a network.