How to Adopt a Local Tariff

From Apr 2017 London will be amending the Integrated Sexual Health Tariff.  If you are currently relying on the existing version of the Tariff to manage your Sexual Health service contracts, or you plan to introduce a Sexual Health Tariff, then you will need to adopt a Local Tariff Arrangement.  

By using the Sexual Health Tariff Grouper service you can easily implement a Local Tariff with minimum fuss and be certain in the knowledge the configuration you specify is strictly applied to Provider activity data.

Local Tariff Arrangements do not have to follow the Currencies in the London ISHT 2017/18, they can adopt any number of local currencies required to cover local commissioning arrangements.

The setup process can take as little as a few days.  

There is a nominal charge for setting up and maintaining the local currencies and participating providers and commissioners will require a subscription to the Sexual Health Grouper service to review and manage their data.  Subscribing Commissioners will also have access to activity delivered to their residents by out of area Providers participating in other local Tariff arrangements.

Steps to adopting a Local Tariff Arrangment

1.  Initial briefing

We give you an initial briefing on the process, this is usually done as a conference call.  This can be with just commissioners or include providers as well.  The briefing covers all aspects of the implementation, at the end of it you should be fully aware of the process and the requirements to complete the process. 

2.  Identify commissioning Lead

In order to agree the participants and authorise the configuration, we need to work with an authorised commissioning Lead.

3.  Identify participating Commissioners

The cluster implementing a local tariff needs to identify a lead commissioner. Each of the Local Authority commissioning areas the tariff arrangements will cover also need to be identified (and subscriber to the Grouper service for automatic tariff rollout). Any single tariff arrangement needs to cover a complete Local Authority areas. Local Authority areas cannot be subdivided with different tariff arrangements in place for different populations.

4.  Identify participating Providers

Each of the Providers participating in the local tariff arrangement should be identified (and subscriber to the Grouper service for automatic tariff rollout)

5.  Draft tariff details

The lead Commissioner specifies the required Currencies, Cross Charging rules, Triggers, Invalid Currency Combinations and Tariff Rates. These can all be based on existing Tariff configurations, for example London ISHT 2017/18. New local Currencies can be configured to track payments for local services such as outreach or opportunistic cervical screens. These details will be contained in web page which the Lead Commissioner will be required to sign-off when they are satisfied the details reflect their requirements.  The details will also include a start and finish date for the tariff to be applied.

6. Sign-off Tariff setup and disseminate new local codes if required

Once you have agreed the tariff configuration, you return to us a signed-off version.  We will advise on the requirement to adopt any new local codes needed to track the required currencies and disseminate these to Providers along with behavioural guidance we have agreed with Commissioners on their use.

7. Go live

The Lead Commissioner will specify a go-live date from which time data submitted to the grouper will use the new local tariff configuration to calculate tariff charges. Data submitted for months within the date range of the new Local Tariff Arrangement will be charged (or Shadow charged) to commissioners in accordance with the cross-charging agreement setup in the configuration.

Issues

  • If any Participating Providers are shared between Commissioners ie they deliver care in clinics located in areas hosted by Commissioners not participating in the new Local Tariff Arrangement, then these providers will need to upload separate data to the Sexual Health Tariff Grouper.
  • If under the proposed new Local Tariff Arrangements providers are required to bill using different tariff charges (other than a difference in MFF or similar 'global' difference in tariff rates) or are required to charge for different Currencies then a separate Local Tariff Arrangement will need to be established for each variation.
  • It is expected that the Local Tariff Rates agreed by the Provider with the Host Commissioner will be available for non-contracted out of area activity and cross-charged at those same agreed rates.  The Sexual Health Tariff Grouper will show out of area Commissioners the charges raised by activity associated with their residents undertaken by Participating Providers.
  • When Local Tariff Rate charges are specified, they need to be considered along with with the required Market Forces Factor (MFF) for the year for the provider concerned.  MFFs can be set to 1.0 (ie neutral) if necessary.
  • If your Sexual Health Service contract conforms to CCG boundaries rather than Local Authority boundaries, then and residents and clinics located inside the CCG but outside the Local Authority boundary will not be charged to or hosted by the Local Authority Host Commissioner.  Care should be taken to ensure that contractual arrangements for Sexual Health Services conform to Local Authority Boundaries.

Next Steps

To take the next step to implement a local tariff configuration please contact us at enquiries@pathwayanalytics.com.  There is an annual maintenance fee that covers the implementation process and supports the development of a limited number of currencies based on current pathways.