BCPRA works hard to ensure that all kidney patients receive equitable access to care regardless of where they live and what level of care they need.
In partnership with health authority renal programs, we manage an annual budget of approximately $170.84 million – funding allocated by the BC Ministry of Health on a per patient/per year basis to BCPRA via the Provincial Health Services Authority.
Our funding model
Renal care is expensive. To ensure rigour and fairness in allocating funds, BCPRA has developed a patient-focused model that provides an accurate assessment of costs and enables flexible care based on each patient’s needs.
Unique in Canada, our funding model is a combination of centralized (at the agency level) and decentralized (at the health authority level) functions. It has attracted the attention of other provinces for its focus on the patient and its ability to accommodate changing healthcare needs.
Benefits of our model:
- Accounts for all the variables that affect the cost of services, for instance the different roles of care providers and the time needed for clinical care
- Provides an accurate assessment of all costs rather than simply an estimate
- Provides for incentives to promote early intervention and patient self-care
- Ensures that all patients, irrespective of where they receive treatment, have access to resources they need (for instance nurse, dietitian, social worker)
- Promotes best practices
- Assists BCPRA and health authority renal programs with planning and with business case development – and facilitates creative solutions
The success of our approach shows in the results: year after year, BCPRA and the health authority renal programs deliver accurate projections of funding needs and consistently deliver on budget.
Out of an annual budget of approximately $172.5 million, BCPRA pays directly for items such as:
- vendor contracts (e.g. producers of dialysis machines and equipment)
- medical and surgical supplies for community dialysis units (provincial contracts are negotiated on behalf of the renal community to realize economies of scale)
- medications (provincial contracts are negotiated for these as well)
- information system costs
- special projects and initiatives
Renal funding is allocated to each health authority for services directly related to patient care:
- labour costs for chronic kidney clinics and peritoneal dialysis clinics
- hemodialysis treatments and follow-up care, including labour costs as well as costs of supplies for hospital units (supplies for community units and home patients are part of a provincial contract managed by BCPRA)
- data entry related to PROMIS, the provincial information system that supports tracking of patient numbers, outcomes and other information
While we recognize that chronic kidney patients use radiology, surgery and other hospital-based programs, the renal funding model is based on chronic dialysis-related services and as such is not intended to cover costs for acute episodic services used by these patients.
In this case, renal care funding is similar to other funding models such as open-heart surgery or cancer treatments, which do not cover the cost of readmission to hospital as a result of complications from these procedures or from other diseases.
Therefore, renal funding does not cover:
- radiology and surgical services, including vascular access surgery procedures
- general pharmacy drug costs such as antibiotics
- inpatient costs associated with hospital admissions
- laboratory costs
- hospital information systems support costs/computer hardware (except in specific circumstances)
- corporate overhead costs
- inflationary and wage settlement cost pressures