Silver Chain - Casemix Phase 1

Silver Chain Health - Casemix capacity building Phase 1

Silver Chain Group
Duration: June 2016 – October 2016


Silver Chain Group is currently looking to expand its home-based care service across Australia and has recognised the need to better understand the drivers of cost to ensure continued market leadership and sustainability. To achieve this successfully, organisational decision-making requires information about the complexity of client need and ways in which models of service provision drive costs and market competitiveness. It was determined that a casemix-based approach to management would provide the support needed to meet the stated Silver Chain goals and the specifications of a three-phased project were developed in 2016 to address the issue of capacity to adopt such a system. The overall project was described as a casemix capacity development program with duration of 18-24 months.

The first project phase was undertaken in 2016 and this involved a gap analysis of client related and financial information systems in their capacity to support costing and classification development and the skills and capacity of staff to undertake casemix analysis.

What we did

This project included several activities such as a literature review, stakeholder consultations, and review of Silver Chain documentation and data. The focus of the literature search was the variables that could be used in a community care-based classification system and the stakeholder consultations and the review of documentation were undertaken to understand the current gaps and identify priority areas for further development work.

This project investigated the data and information management systems for direct and indirect client, and non-client related activities within Silver Chain Health and their related expenditure. The specific focus of the cost analysis was on the types of services and client characteristics that appear to drive the costs of care delivery. The types of costs that are relatively fixed versus those that are driven by service volume or complexity were also identified.

The key deliverable of this project was a report that identified priority concerns with recommendations for further work. Also included in the report was a draft Silver Chain data model and a first draft data dictionary for client related and financial data collection.

The Silver Chain information system is a rich resource which captures data in sufficient detail to support a classification development and activity based costing. However, significant improvements would be needed in the linking of relevant clinical variables to the services delivered, and in the definition of different types of costs in order to achieve high quality data suitable for casemix analytics. The development of the necessary casemix capacity also requires the establishment of a system of data and information system governance within Silver Chain.

Last reviewed: 22 March, 2017

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