South Australian report, April 2013

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In this report:

This report includes the following tables:

This report is issued by the Administrator of the National Health Funding Pool under section 240 of the National Health Reform Act 2011.

This report is prepared on a cash basis. It shows monthly and year-to-date (YTD) National Health Reform (NHR) funding and payments for South Australia for April 2013 as part of the National Health Reform Agreement.

Participation in the National Health Funding Pool – South Australia, April 2013

In signing the National Health Reform Agreement (the Agreement), it was the intention of all states and territories that they would have the necessary legislation in place to enable them to participate in the National Health Funding Pool from 1 July 2012.

However, not all states and territories had their legislation in place by that date. As part of the transition to National Health Reform funding, arrangements were put in place whereby those states and territories received equivalent funding directly from the Commonwealth Treasury, and made payments directly from departmental bank accounts to local hospital networks (LHNs). Although these transactions were not made through state pool accounts and state managed funds, they have been included in this report (and designated as ‘notional payments’ into and out of state pool accounts and state managed funds) to enable national comparability for month and year-to-date reporting periods.

South Australia has participated in the National Health Funding Pool since 1 October 2012.

Local hospital networks and National Health Reform

A local hospital network (LHN) is an organisation that provides public hospital services in accordance with the Agreement. A local hospital network can contain one or more hospitals, and is usually defined as a business group, geographical area or community. Every Australian public hospital is part of a local hospital network.

Note: The term ‘local hospital network’ is a national term. Some states and territories use their own terminology to describe these networks, such as local health districts, health organisations, and hospital and health services.

Under the Agreement, local hospital networks receive funding for the following public hospital services:

  • All admitted and non-admitted services
  • All emergency department services provided by a recognised emergency department
  • Other outpatient, mental health, sub-acute services and other services that could reasonably be considered a public hospital service.

Note: Local hospital networks also receive funding from other sources, including the Commonwealth, states and territories, and third parties for the provision of other specific functions and services outside the scope of the Agreement, for example dental services, primary care, home and community care, residential aged care and pharmaceuticals. For further information on total funding to a particular local hospital network, contact the SA Department of Health to view the service agreement for that local hospital network.

Basis for National Health Reform payments – South Australia, April 2013

For the basis of the Commonwealth contribution to NHR funding, see Basis of Commonwealth NHR funding, 2012-13.

The basis used to determine NHR payments to local hospital networks (LHNs) in South Australia for April 2013 was advised by the SA Department of Health to be as follows:

In determining the annual funding allocation for all local hospital networks, the budget has been built up predominantly on an activity basis applying an internally developed allocation methodology that is designed to equitably distribute funding to each local hospital network relative to all local hospital networks in South Australia. This occurs within the confines of a limited funding pool that includes adjustments to recognise cost improvements and the attainment of service efficiencies that are also equitably allocated on an activity basis. Supplementation is provided as block funding where an activity-based approach is not appropriate. This captures the provision of services including sub-acute, teaching, training and research, some mental health services and the delivery of out of hospital strategies incorporating primary health.

Monthly allocations to local hospital networks will vary for a variety of reasons, but they are predominantly cash flow financed based on need which includes the activity demand on hospital services.

Reference information

The financial information outlined in the following report is categorised as:

  • NHR funding – when the Commonwealth or state or territory government pays NHR funding into a state pool account or state managed fund.
  • NHR payments – when NHR funding deposited into a state pool account or state managed fund is paid out of the state pool account by the Administrator, or is paid out of the state managed fund by the state or territory.
  • Notional NHR payments – funds paid into and out of departmental bank accounts to local hospital networks that would have been transacted through the state pool account and/or state managed fund had NHR funding arrangements been in place. Notional payments are included in 2012-13 reporting to enable national comparability for month and year-to-date reporting periods.

State pool account transactions

Table 1a – State pool account transactions – South Australia, April 2013

This table shows funding paid into the South Australian state pool account by the Commonwealth and South Australia, and payments out of the state pool account to local hospital networks, the state managed fund, and the SA Department of Health for April 2013.

NHR funding by source Paid into state pool account Paid out of state pool account
To local hospital networks To state
managed
fund
To state
health department
Total paid out
($) ($) ($) ($) ($)
Commonwealth
ABF funding
64,926,227 64,926,227 64,926,227
Commonwealth
Block funding
15,235,757 15,235,757 15,235,757
Commonwealth
Other funding
1,924,944 1,924,944 1,924,944
Total C'wealth
funding
82,086,928 64,926,227 15,235,757 1,924,944 82,086,928
Total state/territory
funding
220,433,192 181,538,016 0 181,538,016
Grand Total 302,520,119 246,464,243 15,235,757 1,924,944 263,624,944

See definitions and explanatory notes following table 1b.

Table 1b – State pool account transactions YTD – South Australia, April 2013

Following on from table 1a, this table shows year-to-date (YTD) funding paid into the South Australian state pool account by the Commonwealth and South Australia, and YTD payments out of the state pool account to local hospital networks, the state managed fund, and the SA Department of Health as at April 2013. These amounts include notional payments for July, August and September 2012.

NHR funding by source Paid into state
pool account
YTD
Paid out of state pool account YTD
To local hospital
networks
YTD
To state
managed fund
YTD
To state health
department
YTD
Total paid out
YTD
($) ($) ($) ($) ($)
Commonwealth
ABF funding
667,023,437 667,023,437 667,023,437
Commonwealth
Block funding
156,542,005 156,542,005 156,542,005
Commonwealth
Other funding
19,583,285 19,583,285 19,583,285
Total C'wealth
funding
843,148,727 667,023,437 156,542,005 19,583,285 843,148,727
Total state/territory
funding
1,391,484,112 1,202,167,361 0 1,202,167,361
Grand Total 2,234,632,840 1,869,190,798 156,542,005 19,583,285 2,045,316,089

Note: Of the total year-to-date amount of $2,234,632,840 shown in Table 1b as paid into the South Australian state pool account, $578,617,779 was notional year-to-date payments.
Of the total year-to-date amount of $2,045,316,089 shown in Table 1b as paid out of the South Australian state pool account, $578,617,779 was notional year-to-date payments.
No payments were made from the South Australian state pool account in July, August and September 2012, with payments made directly from departmental bank accounts to local hospital networks.

Commonwealth ABF funding represents Acute admitted public, Acute admitted private, Non-admitted, and Emergency department service categories, which are funded by the Commonwealth through the state pool account and subsequently paid to local hospital networks.

Commonwealth Block funding represents Mental health, Small rural and metropolitan hospitals, Sub-acute, Teaching, training and research, and Other categories, which are funded by the Commonwealth and paid to the state managed fund.

Commonwealth Other funding represents other amounts funded by the Commonwealth, transacted through the state pool account and subsequently paid to state or territory health departments. This currently represents the Commonwealth contribution to public health.

State/territory funding represents funding contributions paid by South Australia into its own state pool account, and subsequently paid to local hospital networks within the state and/or to state or territory health departments.

Note: The grey shaded areas in these tables reflect that these amounts are not applicable for a particular 'paid out' column. For example, Commonwealth block funding is only paid to state managed funds and is not applicable for local hospital networks or state or territory health departments.

NHR funding and payments shown in these tables include GST where applicable.

For more information, see National Health Reform funding and payments.

State managed fund transactions

Table 2a – State managed fund transactions – South Australia, April 2013

This table shows funding paid into the South Australian state managed fund by the Commonwealth and South Australia, and payments out of the state managed fund to local hospital networks and other provider organisations for April 2013.

NHR funding by source Paid into state managed fund Paid out of state managed fund
To local hospital networks To Other Total paid out
($) ($) ($) ($)
Commonwealth Block funding 15,235,757 15,235,757
State/territory Block funding 10,500,000 10,500,000
Total 25,735,757 25,735,757 0 25,735,757

See explanatory notes following table 2b.

Table 2b – State managed fund transactions YTD – South Australia, April 2013

Following on from table 2a, this table shows year-to-date (YTD) funding paid into the South Australian state managed fund by the Commonwealth and South Australia, and YTD payments out of the state managed fund as at April 2013. These amounts include notional payments for July, August and September 2012.

NHR funding by source Paid into state
managed fund
YTD
Paid out of state managed fund YTD
To local hospital
networks
YTD
To Other
YTD
Total paid out
YTD
($) ($) ($) ($)
Commonwealth Block funding 156,542,005 156,542,005
State/territory Block funding 216,698,607 216,698,608
Total 373,240,613 373,240,613 0 373,240,613

Block funding represents Mental health, Small rural and metropolitan hospitals, Sub-acute, Teaching, training and research, and Other categories.

Commonwealth Block funding represents Commonwealth block funding contributions paid into the state managed fund from the state pool account, and block payments out of the state managed fund to local hospital networks and other provider organisations.

State/territory Block funding represents South Australian block funding contributions into the state managed fund, and block payments out of the state managed fund to local hospital networks and other provider organisations.

Note: The grey shaded areas in these tables reflect that these block payments cannot at this stage be identified by source of funding (state, territory or Commonwealth contribution).

NHR funding and payments shown in these tables include GST where applicable.

For more, see National Health Reform funding and payments.

NHR funding and payments by service category

Table 3 – NHR funding and payments by service category – South Australia, April 2013

This table shows NHR funding and payments by service category on both a monthly and year-to-date (YTD) basis for South Australia for April 2013. NHR funding and payments are separated into the following service categories – activity-based funding (ABF), block funding, and other funding.

Service category NHR funding NHR payments NHR funding
YTD
NHR payments
YTD
($) ($) ($) ($)
ABF
Acute admitted - public 204,088,246 176,551,240 1,477,288,376 1,342,351,219
Acute admitted - private 11,777,165 10,182,022 87,198,573 78,992,219
Non-admitted 36,345,182 31,437,797 262,273,668 238,357,874
Emergency department 32,715,634 28,293,186 230,252,146 209,489,485
Total ABF (Pool) 284,926,227 246,464,243 2,057,012,763 1,869,190,798
Block
Mental health 10,723,102 10,723,102 142,862,726 142,862,726
Small rural and metro hospitals 4,205,704 4,205,704 78,119,663 78,119,662
Sub-acute 5,850,728 5,850,728 65,150,439 65,150,439
Teaching, training and research 4,443,762 4,443,762 54,120,778 54,120,778
Other 512,461 512,461 32,987,007 32,987,007
Total Block (SMF) 25,735,757 25,735,757 373,240,613 373,240,613
Other
Public health funding 1,924,944 1,924,944 19,583,285 19,583,285
Overdeposit 0 0 0 0
Cross-border 0 0 0 0
Interest 433,192 0 1,494,787 0
Total Other (Pool) 2,358,135 1,924,944 21,078,072 19,583,285
Grand Total 313,020,119 274,124,944 2,451,331,447 2,262,014,696

Total ABF (Pool) is an aggregate of both Commonwealth and state or territory NHR funding and payments for activity-based funding (ABF) which is transacted through the state pool account.

Total Block (SMF) is an aggregate of both Commonwealth and state or territory NHR funding and payments for block funding which is transacted through the state managed fund (SMF).

Total Other (Pool) represents other funding and payments, which are transacted through the state pool account, including public health funding, overdeposits, cross-border funding and payments, and interest. State and territory cross-border payments can either be:

  • Paid to the relevant state or territory's local hospital networks - included within ABF and/or block payments in the above table, or
  • Reimbursed to the relevant state or territory where the state or territory's local hospital networks are already being funded for the cost of treating cross-border patients - shown in the Cross-border row under Other in the above table.

Cross-border funding arrangements between states and territories are yet to be put in place for state and territory contributions.

NHR funding and payments shown in these tables include GST where applicable.

For more information, see National Health Reform funding and payments.

NHR payment distribution by local hospital network

Table 4 – NHR payment distribution by local hospital network – South Australia, April 2013

This table shows NHR payments (from state, territory and Commonwealth sources) made to each local hospital network (LHN) in South Australia during April 2013.

NHR payments distributed to local hospital networks (LHNs) are separated into an activity-based funding (ABF) component and a block component.

Local hospital network (LHN) ABF component
(ex GST)
Block component
(ex GST)
Total NHR payments
(ex GST)
($) ($) ($)
Central Adelaide Local Health Network 77,645,759 16,257,042 93,902,800
Country Health SA Local Health Network 40,632,948 5,292,938 45,925,885
Northern Adelaide Local Health Network 30,349,161 1,532,418 31,881,579
Southern Adelaide Local Health Network 68,754,859 1,907,477 70,662,336
Women's and Children's Health Network 29,081,516 745,883 29,827,399
Total 246,464,243 25,735,757 272,200,000

A local hospital network (LHN) is an organisation that provides public hospital services in accordance with the National Health Reform Agreement. A local hospital network can contain one or more hospitals, and is usually defined as a business group, geographical area or community. Every Australian public hospital is part of a local hospital network.

NHR payments in this table are GST exclusive to enable comparability of NHR payments in each local hospital network report.

Note: This table excludes GST and payments to other provider organisations (non-local hospital networks).
The majority of government funding to local hospital networks is not subject to GST. However in some cases hospital funding to non-government entities does attract GST, for example, denominational hospitals, privately and commercially owned health facilities, or any other non-government third party provider of health services or related supplies.

For more information, see National Health Reform funding and payments.

Estimated monthly, YTD and annual NWAU by local hospital network

States and territories provide NHR funding amounts and service volumes as service estimates at the start of each financial year, and if required, can continue to refine these estimates during the course of the year. These estimates form the basis of monthly reporting of service volumes until actual service numbers become available. These estimates are expressed as National Weighted Activity Units (NWAU).

States and territories provide estimated annual NWAU to the Administrator as a basis for determining the Commonwealth activity-based funding. Current month NWAU estimates accumulate through the year-to-date (YTD) NWAU, to be equal to the annual NWAU at the end of the financial year.

Table 5 – Estimated monthly, YTD and annual NWAU by local hospital network – South Australia, April 2013

This table shows estimated state or territory hospital activity for activity-based funding services expressed as NWAU for April 2013, the associated cumulative year-to-date (YTD), and total estimated annual NWAU for each local hospital network in South Australia.

Local hospital network (LHN) Estimated NWAU delivered in current month Estimated NWAU delivered YTD Estimated annual NWAU 2012-13
Central Adelaide Local Health Network 15,517 135,516 162,612
Country Health SA Local Health Network 8,120 53,320 70,935
Northern Adelaide Local Health Network 6,065 48,007 81,497
Southern Adelaide Local Health Network 13,740 97,456 120,327
Women's and Children's Health Network 5,812 39,485 51,320
Total 49,253 373,784 486,690

An NWAU is a measure of health service activity expressed as a common unit. It provides a way of comparing and valuing each public hospital service, whether they are admissions, emergency department presentations or outpatient episodes, by weighting them for their clinical complexity. The average hospital service is worth one NWAU - the most intensive and expensive activities are worth multiple NWAU, the simplest and least expensive are worth fractions of an NWAU.

Monthly NHR payments relate to the cash needs of public hospitals and do not necessarily reflect the volume of services to be delivered in the month.

For more information on the NWAU calculation, see Calculation of NWAU.