South Australian report, December 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 December 2013 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, December 2013

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 December 2013 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.

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, December 2013

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 December 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
To state pool (other State) Total paid out
($) ($) ($) ($) ($) ($)
Commonwealth
ABF funding
71,337,458 71,337,458 71,337,458
Commonwealth
Block funding
12,120,107 12,120,107 12,120,107
Commonwealth
Other funding
1,963,592 1,963,592 1,963,592
Total C'wealth
funding
85,421,157 71,337,458 12,120,107 1,963,592 85,421,157
SA
funding
150,291,309 180,174,434 0 0 180,174,434
Other state/territory funding 0 0
Total 235,712,466 251,511,892 12,120,107 1,963,592 0 265,595,591

See definitions and explanatory notes following table 1b.

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

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
428,021,493 428,021,493 428,021,493
Commonwealth
Block funding
72,720,089 72,720,089 72,720,089
Commonwealth
Other funding
11,781,553 11,781,553 11,781,553
Total C'wealth
funding
512,523,135 428,021,493 72,720,089 11,781,553 512,523,135
SA
funding
1,081,150,390 929,554,197 0 0 929,554,197
Other state/territory funding 0 0
Total 1,593,673,524 1,357,575,690 72,720,089 11,781,553 0 1,442,077,331

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, December 2013

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 December 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 12,120,107 12,120,107
State/territory Block funding 7,500,000 7,500,000
Total 19,620,107 19,620,107 0 19,620,107

See explanatory notes following table 2b.

Table 2b – State managed fund transactions YTD – South Australia, December 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 December 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 72,720,089 72,720,089
State/territory Block funding 93,536,221 93,536,221
Total 166,256,310 166,256,310 0 166,256,310

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, December 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 December 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 YTD NHR
funding
YTD NHR
payments
($) ($) ($) ($)
ABF
Acute admitted - public 133,213,949 150,326,865 910,586,149 817,986,154
Acute admitted - private 9,359,311 10,833,121 63,763,529 58,116,559
Non-admitted 30,644,819 35,140,110 200,451,150 187,294,441
Emergency department 22,863,767 25,008,519 164,487,314 139,481,740
Admitted mental health 8,494,785 10,182,393 56,250,046 51,389,295
Sub-acute 16,760,827 20,020,885 112,483,307 103,307,501
Total ABF (Pool) 221,337,458 251,511,892 1,508,021,493 1,357,575,690
Block
Non-admitted mental health 5,738,532 5,738,556 45,106,861 45,106,907
Small rural hospitals 5,599,772 5,599,764 75,125,232 75,125,217
Teaching, training & research 6,394,096 6,394,094 32,857,930 32,857,926
Other non-admitted services 1,887,706 1,887,693 13,166,286 13,166,260
Total Block (SMF) 19,620,107 19,620,107 166,256,310 166,256,310
Other
Public health funding 1,963,592 1,963,592 11,781,553 11,781,553
Overdeposit 0 0 0 0
Cross-border 0 0 0 0
Interest 291,309 0 1,150,390 0
Total Other (Pool) 2,254,901 1,963,592 12,931,943 11,781,553
Grand Total 243,212,466 273,095,591 1,687,209,745 1,535,613,552

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, December 2013

This table shows NHR contributions (from state, territory and Commonwealth sources) made to each LHN in South Australia during December 2013.

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 110,893,739 6,106,261 117,000,000
Country Health SA Local Health Network 14,139,093 7,002,907 21,141,999
Northern Adelaide Local Health Network 37,557,578 1,232,422 38,790,000
Southern Adelaide Local Health Network 63,837,413 3,862,587 67,700,000
Women's and Children's Health Network 25,084,070 1,415,930 26,500,000
Total 251,511,892 19,620,107 271,131,999

See explanatory notes below table 4b.

Table 4b – NHR contributions by local hospital network YTD – South Australia, December 2013

This table shows YTD NHR contributions (from state, territory and Commonwealth sources) made to each LHN in South Australia as at December 2013.

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 544,162,530 39,037,470 583,200,000
Country Health SA Local Health Network 149,088,658 99,653,341 248,741,999
Northern Adelaide Local Health Network 169,295,523 7,394,477 176,690,000
Southern Adelaide Local Health Network 349,624,541 14,275,459 363,900,000
Women's and Children's Health Network 145,404,438 5,895,562 151,300,000
Total 1,357,575,690 166,256,310 1,523,831,999

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, December 2013

This table shows estimated state or territory hospital activity for activity-based funding services expressed as NWAU for December 2013, 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 22,082 108,356 195,793
Country Health SA Local Health Network 2,815 29,687 57,384
Northern Adelaide Local Health Network 7,479 33,711 92,925
Southern Adelaide Local Health Network 12,712 69,619 137,147
Women's and Children's Health Network 4,995 28,953 54,916
Total 50,082 270,326 538,164

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.