South Australian report, March 2013

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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 March 2013 as part of the National Health Reform Agreement.

Participation in the National Health Funding Pool

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

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 South Australian Department of Health to view the service agreement for that local hospital network.

Basis for National Health Reform payments

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

The basis used to determine NHR payments to local hospital networks (LHNs) in South Australia for March 2013 was advised by South Australia 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 the 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.

Transactions on the state pool account

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 state health department for March 2013.

Table 1a – State pool account transactions – South Australia, March 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 Commonwealth
funding
82,086,928 64,926,227 15,235,757 1,924,944 82,086,928
Total state/territory
funding
120,370,376 140,337,398 0 140,337,398
Grand Total 202,457,304 205,263,626 15,235,757 1,924,944 222,424,326

See definitions and explanatory notes following table 1b.

Following on from table 1a, this table shows the year-to-date (YTD) 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 state health department as at March 2013. These amounts include notional payments for July, August and September 2012.

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

NHR funding by source Paid into state pool account YTD Paid out of state pool account YTD
To local hospital networks To state managed
fund
To state health department Total paid out
YTD
($) ($) ($) ($) ($)
Commonwealth
ABF funding
602,097,210 602,097,210 602,097,210
Commonwealth
Block funding
141,306,249 141,306,249 141,306,249
Commonwealth
Other funding
17,658,341 17,658,341 17,658,341
Total Commonwealth
funding
761,061,800 602,097,210 141,306,249 17,658,341 761,061,800
Total state/territory
funding
1,171,050,921 1,020,629,345 0 1,020,629,345
Grand Total 1,932,112,720 1,622,726,555 141,306,249 17,658,341 1,781,691,145

Note: Of the total year-to-date amount of $1,932,112,720 shown in Table 1b as paid into the South Australian state pool account, $578,617,779 was notional year-to-date payments.

Note: Of the total year-to-date amount of $1,781,691,145 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 in by South Australia into its own state pool account, and subsequently paid to local hospital networks within the state or territory 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 on NHR funding and payments, see National Health Reform funding and payments.

Transactions on the state managed fund

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 for March 2013.

Table 2a – State managed fund transactions – South Australia, March 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 18,900,618 18,900,618
Total 34,136,374 34,136,374 0 34,136,374

See explanatory notes following table 2b.

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

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

NHR funding by source Paid into state managed fund YTD Paid out of state managed fund YTD
To local hospital networks To Other Total paid out
YTD
($) ($) ($) ($)
Commonwealth Block funding 141,306,249 141,306,249
State/territory Block funding 206,198,607 206,198,608
Total 347,504,856 347,504,857 0 347,504,857

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 information on NHR funding and payments, see National Health Reform funding and payments.

NHR funding and payments by service category

This table shows the NHR funding and payments by service category on both a monthly and year-to-date (YTD) basis for South Australia for March 2013.

NHR funding and payments are separated into an activity based funding (ABF) component, block component, and other components.

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

Service category NHR funding NHR payments NHR funding
YTD
NHR payments
YTD
($) ($) ($) ($)
ABF
Acute admitted - public 132,758,095 147,363,686 1,273,200,130 1,165,799,979
Acute admitted - private 7,729,947 8,590,371 75,421,407 68,810,198
Non-admitted 23,861,843 26,503,430 225,928,486 206,920,078
Emergency department 20,576,342 22,806,138 197,536,512 181,196,300
Total ABF (Pool) 184,926,227 205,263,626 1,772,086,535 1,622,726,555
Block
Mental health 12,322,194 12,322,194 132,139,623 132,139,623
Small rural & metro hospitals 7,743,622 7,743,622 73,913,959 73,913,959
Sub-acute 6,243,660 6,243,660 59,299,711 59,299,711
Teaching, training & research 4,780,311 4,780,311 49,677,016 49,677,016
Other 3,046,587 3,046,587 32,474,547 32,474,547
Total Block (SMF) 34,136,374 34,136,374 347,504,856 347,504,857
Other
Public health funding 1,924,944 1,924,944 17,658,341 17,658,341
Overdeposit 0 0 0 0
Cross border 0 0 0 0
Interest 370,376 0 1,061,595 0
Total Other (Pool) 2,295,320 1,924,944 18,719,936 17,658,341
Grand Total 221,357,921 241,324,944 2,138,311,328 1,987,889,753

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 payment 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 on NHR funding and payments, see National Health Reform funding and payments.

NHR payment distribution by LHN

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

NHR payments are separated into an activity based funding (ABF) component and a block component.

Table 4 – NHR payment distribution by LHN – South Australia, March 2013

Local hospital network (LHN) ABF component
(ex GST)
Block component
(ex GST)
Total NHR payments
(ex GST)
($) ($) ($)
Central Adelaide Local Health Network 71,400,000 13,800,000 85,200,000
Country Health SA Local Health Network 27,432,948 10,767,052 38,200,000
Northern Adelaide Local Health Network 25,749,161 1,650,839 27,400,000
Southern Adelaide Local Health Network 56,000,000 7,000,000 63,000,000
Women's and Children's Health Network 24,681,516 918,484 25,600,000
Total 205,263,626 34,136,374 239,400,000

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).

Note: 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 on NHR funding and payments, see National Health Reform funding and payments.

Estimated monthly, YTD and annual NWAU by LHN

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

NHR funding amounts and service volumes are provided by states and territories as service estimates at the start of each financial year, and may continue to be refined during the course of the year. These estimates form the basis of monthly reporting of service volumes until actual service numbers become available.

The estimated annual NWAU for each local hospital network (LHN) was provided to the Administrator as a basis for determining the Commonwealth NHR activity based funding. Current month NWAU estimates accumulate through the year-to-date NWAU to equal the annual NWAU at the end of the financial year.

Table 5 – Estimated monthly, YTD and annual NWAU by LHN – South Australia, March 2013

Local hospital network (LHN) Estimated NWAU delivered in current month Estimated NWAU delivered YTD Estimated annual NWAU 2012-13
Central Adelaide Local Health Network 14,269 119,999 162,612
Country Health SA Local Health Network 5,482 45,200 70,935
Northern Adelaide Local Health Network 5,146 41,942 81,497
Southern Adelaide Local Health Network 11,191 83,716 120,327
Women's and Children's Health Network 4,932 33,673 51,320
Total 41,020 324,530 486,690

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 NHR funding and payments, see National Health Reform funding and payments.

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