The Minimum Practice Income Guarantee

1
The Minimum Practice Income Guarantee

• A Guarantee in Perpetuity

2
Principles of the MPIG

• Practices income should be protected
• All practices should start the new contract from
  either a neutral basis or with an uplift
• Assumes a minimum level of quality
• The guarantee is permanent
• The guarantee will be applied according to an
  objective test/measure

3
Practice income should be protected

• Global sum equivalent (GSE) of Red Book payments
  i.e. only those items that read across
• GSE is compared to the global sum allocation via
  the formula
• If global sum is more than GSE - no need for MPIG
• If global sum is less than GSE - MPIG
• This ensures no practice loses income

4
Correction factor

• If global sum is less than the GSE, need to make
  up the difference
• The difference is made up by the correction
  factor (CF) (and the value of 100(150) quality
  points)
• MPIG global sum via formula CF

5
This means that the global sum or the MPIG
includes ...

• All the GSE money now/previously paid to a
  practice that used to be called deprivation, or
  mileage payments, or staff reimbursements, or
  whatever
• The only change is that they wont be called that
  any more, collectively they will be called the
  global sum or the MPIG

6
But...

• For the purposes of calculating the CF only
• the value of 100/150 quality points is
  offset/deducted
• It is not the loss or removal of 100/150 quality
  points
• GSE - global sum - value of 100/150 points
• the correction factor

7
Global sum equivalent income under Red
Book payments (Uprated to 2004/05 value)
Value of 100 points
Correction factor
Global sum following application of the formula
8
For example in 2004/5

• GSE 2003/4 325,219
• Uplift 1.47 for 2004/5 330,000
• Global sum via formula 300,000
• Difference 30,000
• Less value of 100 points
• (at 75 per point for this practice)
  7,500
• Correction factor 22,500
• MPIG 300K CF 322,500

9
Other income
300 quality points
Value of 100 points
Global sum equivalent income under Red
Book payments (Uprated to 2004/05 value)
Correction factor
Correction factor
Global sum following application of the formula
Global sum following application of the formula
10
In 2005/6...

• Original difference 30,000
• Uplift 1.47
• as per global sum 30,441
• Less value of 150 points
• (at 120 per point for this practice)
  18,000
• New correction factor 12,441
• MPIG 304,410 CF 316,851
• (in 2004/5
  322,500)

11
Other income
300 quality points
Global sum equivalent income under Red
Book payments (irrelevant to 2005/6 CF
calculation)
Value of 150 points
Correction factor
Correction factor
Global sum following application of the formula
Global sum following application of the formula
12
The Correction Factor

• Fixed for 12 months in 2004/5 (value of 100
  points adjustment)
• Fixed from 2005/6 (value of 150 points
  adjustment)
• Only changed following a formula review
• Will be annually uplifted
• Floats on top of global sum, which can
  fluctuate with practice population changes
• MPIG concept will remain in perpetuity

13
To be honest...

• Deduction of value of 100 points and 150 points
  in the calculation
• in original transition scheme
• encourages quality uptake
• helps pay for MPIG protection BUT..
• Opportunity to earn well over this value without
  new work

14
The value of 100 points

• Minimum organisational and patient experience
  indicators 169
• Average practice 350 comfortably (5-600)
• Not new work - we do this level of quality now
  (compare to SQA/CDM)

15
Sustained Quality Allowance

• 690 per GP (3 GPs 2,100 28 points )
• Access like target 50 points (DES)
• Notes - date ordered tagged 2 points
• CDM (register review) 79 points
• Medicines management 13 points
• Total for SQA in quality 144 points
• Income under quality 10,800

16
How to get the 100 back

• Organisational (minimum) 106
• Patient experience 63
• Total 169
• CDM in SQA only 79
• Total 238
• Earnings under quality
• (at 75 per point for this practice) 17,850
• 17,850 - 7,500 10,350
• SQA bare minimum 144

17
SO...

• an average practice
• in the 1st year
• achieving 300 points, gains 15,000
• achieving 600 points, gains 37,500
• in the 2nd year
• achieving 300 points, gains 18,000
• achieving 600 points, gains 54,000

18
Total Practice Income

• Global sum/MPIG is only part of total practice
  income
• Total practice income global sum/MPIG quality
  (preparation, aspiration and achievement)
  seniority PCO payments (eg maternity, sickness)
  enhanced services
• plus outside work (eg hospital, private)
• cost savings (eg OOH, IT)