Advisory Report on Information Management in the Federal Health Claims Processing Service Contract
Table of Contents
Alternate Formats
Assistant Deputy Minister (Review Services)
- ADM(RS)
- Assistant Deputy Minister (Review Services)
- CAF
- Canadian Armed Forces
- CFHS
- Canadian Forces Health Services
- DND
- Department of National Defence
- FHCPS
- Federal Health Claims Processing Service
- FY
- Fiscal Year
- MBC
- Medavie Blue Cross
- MPC
- Military Personnel Command
- OPI
- Office of Primary Interest
- RCMP
- Royal Canadian Mounted Police
- VAC
- Veterans Affairs Canada
Details of Figure 1 - Overview of Medical Services provided via FHCPS Contract
| Fiscal Year | Total Spending ($ millions) | Spending Growth (%) (year over year) | # of Medical Services Provided (millions) | # of Members Treated (thousands) | Approximate Average Transaction Value ($) |
|---|---|---|---|---|---|
| 2010/11 | 108 | ~ | 1.36 | 66 | ▓▓▓ |
| 2011/12 | 117 | 8.3 | 1.45 | 65 | ▓▓▓ |
| 2012/13 | 118 | 0.9 | 1.39 | 64 | ▓▓▓ |
| 2013/14 | 120 | 1.7 | 1.34 | 63 | ▓▓▓ |
| 2014/15 | 118 | -1.7 | 1.33 | 61 | ▓▓▓ |
| 2015/16 | 129 | 9.3 | 1.18 | 61 | ▓▓▓ |
| 2016/17 | 144 | 11.6 | 1.20 | 64 | ▓▓▓ |
Table 1 Details - Overview of Data from the FHCPS Contract
Figure 2. Data Maturity Model. This graph describes the data management practices and activities of an organization to determine the capability of an organization performing data analytics by using a maturity framework.
Figure 2 Details - Data Analytics Maturity Model
Table 2 Details - Summary of Results by Area Examined
Figure 3 Details - Assessment of CFHS in the Data Analytics Maturity Model
ADM(RS) Recommendation (Moderate)
ADM(RS) Recommendation (High)
ADM(RS) Recommendation (High)
ADM(RS) Recommendation (High)
ADM(RS) Recommendation (High)
ADM(RS) Recommendation (High)
Table 3 Details - Possible Duplicate Transactions
| Medical Procedure Descriptions & Benefit Codes | Lowest Average Fee | Highest Average Fee | % Difference in Average Max/Min | Highest Fee Paid by Service Type | Total $ paid (over 7 years) | |||
|---|---|---|---|---|---|---|---|---|
| Province | Minimum Average $ | Province | Maximum Average $ | Province | Maximum Fee Paid $ | |||
| RADIOGRAPHS, INTRAORAL, PERIAPICAL, SINGLE FILM (002111) | BC | $17.21 | ON | $27.72 | 161% | ON | $1,307.00 | $138,805 |
| OUT-PATIENT VISIT (120013) | QC | $46.56 | ON | $293.17 | 630% | BC | $5,482.00 | $50,237,555 |
| PHYSIOTHERAPY - ASSESSMENT (240116) | MB | $62.62 | NT | $210.48 | 336% | NB | $1,300.00 | $5,046,099 |
| COMPLETE HEARING ASSESSMENT (320625) | NL | $61.61 | MB | $74.78 | 121% | ON | $650.00 | $773,691 |
| OTHER ELIGIBLE MEDICAL SUPPLIES - PURCHASE (402518) | QC | $35.38 | NB | $288.46 | 815% | AB | $8,218.50 | $645,945 |
| FOOTWEAR AND RELATED ACCESSORIES - CUSTOM-MADE RIGHT/LEFT (503130) | NS | $73.80 | SK | $220.26 | 298% | AB | $2,400.00 | $3,560,589 |
| MAJOR OPTOMETRIC EXAM (600014) | NL | $65.75 | BC | $111.52 | 170% | NS | $985.00 | $5,875,556 |