South Australian report, April 2014

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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 2014 as part of the National Health Reform Agreement.

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. An LHN 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 an LHN.

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, LHNs 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: LHNs 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 LHN, contact the SA Department of Health to view the service agreement for that LHN.

Basis for National Health Reform payments – South Australia, April 2014

For the basis of the Commonwealth contribution to NHR funding, see Basis of Commonwealth NHR funding, 2013-14.

The basis used to determine NHR payments to LHNs in South Australia for April 2014 was advised by the SA Department of Health to be as follows:

In determining the annual funding allocation for all LHNs, 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 LHNs 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 teaching, training and research, some mental health services and the delivery of out of hospital strategies incorporating primary health.

Monthly allocations to LHNs 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.

In March 2014, the Commonwealth provided South Australia with additional public hospital funding of $8,186,383.03 under the 2013-14 Mid-Year Economic and Fiscal Outlook (MYEFO) funding measure: Public Hospital System - additional funding. This funding was provided to offset the downward adjustment to 2013-14 NHR funding applied at the MYEFO due to the application of updated NHR funding indexation parameters. A requirement of the provision of this funding was that the funding be provided to LHNs through the National Health Funding Pool and / or State Managed Fund.

The Administrator has been advised by South Australia that as a result of the additional funding from the Commonwealth, the South Australian contributions to LHNs through the Pool will not be reduced and remain as otherwise expected to meet their funding requirements.

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 that has been 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.

State pool account transactions

Table 1a – State pool account transactions – South Australia, April 2014

This table shows funding paid into the South Australian state pool account by the Commonwealth, South Australia or other states/territories, and payments out of the state pool account to LHNs, the state managed fund, the SA Department of Health or the state pool accounts of other states/territories for April 2014.

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
To state pool (other State) Total paid out
($) ($) ($) ($) ($) ($)
Commonwealth
ABF funding
70,190,209 70,190,209 70,190,209
Commonwealth
Block funding
11,925,481 11,925,481 11,925,481
Commonwealth
Other funding
1,929,278 1,929,278 1,929,278
Total C'wealth
funding
84,044,968 70,190,209 11,925,481 1,929,278 84,044,968
SA
funding
120,449,039 131,536,734 0 0 131,536,734
Other state/territory funding 0 0 0 0
Total 204,494,007 201,726,943 11,925,481 1,929,278 0 215,581,702

See definitions and explanatory notes following table 1b.

Table 1b – State pool account transactions YTD – South Australia, April 2014

Following on from table 1a, this table shows year-to-date (YTD) funding paid into the South Australian state pool account by the Commonwealth, South Australia or other states/territories, and payments out of the state pool account to LHNs, the state managed fund, the SA Department of Health or the state pool accounts of other states/territories as at April 2014.

NHR funding by source Paid Into state
pool account
Paid Out of state pool account
To Local hospital
networks
YTD
To State
Managed Fund
YTD
To state health
department
YTD
To state pool (other State)
YTD
Total paid out
YTD
($) ($) ($) ($) ($) ($)
Commonwealth
ABF funding
709,488,506 709,488,506 709,488,506
Commonwealth
Block funding
120,541,412 120,541,412 120,541,412
Commonwealth
Other funding
19,523,649 19,523,649 19,523,649
Total C'wealth
funding
849,553,566 709,488,506 120,541,412 19,523,649 849,553,566
SA
funding
1,752,762,305 1,562,455,629 0 0 1,562,455,629
Other state/territory funding 0 0 0 0
Total 2,602,315,872 2,271,944,134 120,541,412 19,523,649 0 2,412,009,195

Commonwealth ABF funding represents Acute admitted public, Acute admitted private, Non-admitted, and Emergency department, Sub-acute, and Admitted mental health service categories, which are funded by the Commonwealth through the state pool account and subsequently paid to LHNs.

Commonwealth Block funding represents Non-admitted mental health, Small rural hospitals, Teaching, training & research, and Other non-admitted 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.

SA funding represents funding contributions paid by South Australia into its own state pool account, and subsequently paid to LHNs within the state, to the South Australian health department and/or to other state pool accounts.

Other state/territory funding represents contributions paid to South Australia by other states and territories for cross-border activity.

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 2014

This table shows funding paid into the South Australia state managed fund by the Commonwealth and South Australia, and payments out of the state managed fund to LHNs and other provider organisations for April 2014.

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 11,925,481 11,925,481
State/territory Block funding 22,247,576 22,247,576
Total 34,173,057 34,173,057 0 34,173,057

See explanatory notes following table 2b.

Table 2b – State managed fund transactions YTD – South Australia, April 2014

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 2014. 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 120,541,412 120,541,412
State/territory Block funding 162,712,707 162,712,707
Total 283,254,119 283,254,119 0 283,254,119

Block funding represents Non-admitted mental health, Small rural hospitals, Teaching, training & research, and Other non-admitted 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 LHNs 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 LHNs 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 2014

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 2014. 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 YTD NHR
funding
YTD NHR
payments
($) ($) ($) ($)
ABF
Acute admitted - public 114,375,600 121,815,750 1,482,971,733 1,368,736,441
Acute admitted - private 7,562,952 7,735,695 101,548,849 93,617,904
Non-admitted 26,563,360 28,373,467 332,258,869 314,267,756
Emergency department 20,034,054 21,940,346 265,669,744 238,331,866
Admitted mental health 7,540,297 7,765,396 93,967,056 87,476,940
Sub-acute 14,113,946 14,096,289 183,072,255 169,513,227
Total ABF (Pool) 190,190,209 201,726,943 2,459,488,506 2,271,944,134
Block
Non-admitted mental health 10,719,715 10,719,715 80,149,937 80,149,984
Small rural hospitals 10,596,405 10,596,405 111,722,421 111,722,405
Teaching, training & research 8,637,798 8,637,798 65,670,085 65,670,081
Other non-admitted services 4,219,139 4,219,139 25,711,676 25,711,649
Total Block (SMF) 34,173,057 34,173,057 283,254,119 283,254,119
Other
Public health funding 1,929,278 1,929,278 19,523,649 19,523,649
Overdeposit 0 0 0 0
Cross-border 0 0 0 0
Interest 449,039 0 2,762,305 0
Total Other (Pool) 2,378,317 1,929,278 22,285,955 19,523,649
Grand Total 226,741,583 237,829,278 2,765,028,579 2,574,721,902

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 LHNs - 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 LHNs are already being funded for the cost of treating cross-border patients - shown in the Cross-border row under Other in the above table.

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

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

NHR contributions by local hospital network

Table 4a – NHR contributions by local hospital network – South Australia, April 2014

This table shows NHR contributions (from state, territory and Commonwealth sources) made to each LHN in South Australia during April 2014.

NHR contributions to 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 payment
(ex GST)
($) ($) ($)
Central Adelaide Local Health Network 52,216,072 5,783,928 58,000,000
Country Health SA Local Health Network 22,379,107 14,120,893 36,500,000
Northern Adelaide Local Health Network 44,115,688 9,384,312 53,500,000
Southern Adelaide Local Health Network 59,758,248 3,741,752 63,500,000
Women's and Children's Health Network 23,257,829 1,142,171 24,400,000
Total 201,726,943 34,173,057 235,900,000

See explanatory notes below table 4b.

Table 4b – NHR contributions by local hospital network YTD – South Australia, April 2014

This table shows YTD NHR contributions (from state, territory and Commonwealth sources) made to each LHN in South Australia as at April 2014.

NHR contributions to LHNs are separated into an activity-based funding (ABF) component and a block component.

Local hospital network ABF component YTD
(ex GST)
Block component YTD
(ex GST)
Total NHR payment YTD
(ex GST)
($) ($) ($)
Central Adelaide Local Health Network 822,886,827 58,437,117 881,323,944
Country Health SA Local Health Network 239,721,256 147,514,619 387,235,875
Northern Adelaide Local Health Network 394,718,746 27,608,817 422,327,563
Southern Adelaide Local Health Network 580,969,497 38,962,743 619,932,240
Women's and Children's Health Network 233,647,808 10,730,823 244,378,631
Total 2,271,944,134 283,254,119 2,555,198,253

NHR contributions in this table are GST exclusive to enable comparability of NHR payments in each LHN report.

Note: This table excludes GST.
The majority of government funding to LHNs 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 activity

States and territories provide service volume 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.

States and territories may also provide activity information relating to the delivery of other public hospital functions funded.

Table 5 – Estimated monthly, YTD and annual NWAU by local hospital network – South Australia, April 2014

This table shows estimated state or territory hospital activity for activity-based funding services expressed as NWAU for April 2014, the associated cumulative year-to-date (YTD), and total estimated annual NWAU for each LHN in South Australia.

Local hospital network (LHN) Estimated NWAU delivered in current month Estimated NWAU delivered YTD Estimated annual NWAU 2013-14
Central Adelaide Local Health Network 10,397 163,856 195,793
Country Health SA Local Health Network 4,456 47,734 57,384
Northern Adelaide Local Health Network 8,784 78,598 92,925
Southern Adelaide Local Health Network 11,899 115,685 137,147
Women's and Children's Health Network 4,631 46,525 54,916
Total 40,169 452,398 538,164

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.