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Casemix in Ireland is run on a retrospective basis. Budget adjustments are made that relate to costs and activity for the calendar year two years previously. This is presently changing to a prospective funding model which will be informed by a Patient Level Costing project currently in progress.  The Irish Casemix budget models are subject to a rigorous audit process. A unique aspect of Casemix in Ireland is that it is budget neutral. The effect of this is that the performance of one hospital affects all of its peer hospitals. To ensure confidence in the process, there is a detailed audit done on the costs and activity of each hospital. Cost audits have been part of the annual Casemix process since Casemix was introduced in Ireland in 1991. In recent years, the National Casemix Programme (NCP) has put an increased focus on activity auditing.  The staff in the NCP have direct access to and regular communication with costing and coding staff in each hospital. This access is essential in enabling a thorough audit process.

Auditing in the Irish Casemix budget models