Tasmanian 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 Tasmania 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 Tasmanian Department of Health and Human Services to view the service agreement for that LHN.

Basis for National Health Reform payments – Tasmania, 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 Tasmania for December 2013 was advised by the Tasmanian Department of Health and Human Services to be as follows:

Tasmania has developed a funding model (Tasmanian ABF Model) which will take a prospective orientation (i.e. it will produce the forward allocation based on the volumes of services to be funded that are determined in accordance with State planning processes). While in 2013-14 THO budget allocations continued to be developed on a historical basis, the ABF Model was used to develop an activity profile and block funded services allocation for each THO for 2013-14, capped by the historical budget allocation.

The funding arrangements and associated pricing focussed on the four ABF work streams of:

  • acute admitted,
  • other admitted (include sub-acute admitted and mental health), and
  • emergency department

Tasmanian pricing applied in 2013-14 with THOs has not used the NEP. In this regard, Tasmania has used the national average cost per work stream based on Round 15 National Health Cost Data Collection (NHCDC) data for 2010-11 indexed to 2013-14. For ICU and non-admitted, the State Average cost has been used. The National Average Cost was considered the most appropriate (where available) as it provides a National benchmark without the complication of NWAUs and the NEP.

Therefore the 2013-14 Tasmanian ABF Model pricing is based on the following:

  • Overnight Acute Admitted Patients and Same day Admitted Patients- price per weighted separation (National Average Cost indexed),
  • Length of Stay Outliers - a per diem rate will be paid (based on the National Average Cost indexed),
  • ICU Cases - the proposed pricing model will be based on (State Average Cost indexed)
    • price per ICU hour, and
    • price per hour of mechanical ventilation.
  • Non Admitted Patients - price per service event (State Average Cost indexed).
  • Emergency Department Patients - price per UDG (Urgency Disposition Group) (National Average Cost indexed).

The Tasmanian ABF Model also allocates block grants to THOs covering services provided and activities undertaken that are not within the ABF work streams. This includes teaching, training and research, non ABF hospitals and other operational grants costs which are deemed out of scope for Commonwealth funding.

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 – Tasmania, December 2013

This table shows funding paid into the Tasmanian state pool account by the Commonwealth, Tasmania or other states/territories, and payments out of the state pool account to LHNs, the state managed fund, the Tasmanian Department of Health and Human Services 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
20,452,807 20,452,807 20,452,807
Commonwealth
Block funding
4,277,742 4,277,742 4,277,742
Commonwealth
Other funding
601,254 601,254 601,254
Total C'wealth
funding
25,331,803 20,452,807 4,277,742 601,254 25,331,803
TAS
funding
31,474,006 31,474,001 0 0 31,474,001
Other state/territory funding 0 0
Total 56,805,809 51,926,808 4,277,742 601,254 0 56,805,804

See definitions and explanatory notes following table 1b.

Table 1b – State pool account transactions YTD – Tasmania, December 2013

Following on from table 1a, this table shows year-to-date (YTD) funding paid into the Tasmanian state pool account by the Commonwealth, Tasmania or other states/territories, and payments out of the state pool account to LHNs, the state managed fund, the Tasmanian Department of Health and Human Services 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
126,819,337 126,819,337 126,819,337
Commonwealth
Block funding
21,577,370 21,577,370 21,577,370
Commonwealth
Other funding
3,607,526 3,607,526 3,607,526
Total C'wealth
funding
152,004,233 126,819,337 21,577,370 3,607,526 152,004,233
TAS
funding
191,235,011 191,232,646 0 0 191,232,646
Other state/territory funding 0 0
Total 343,239,244 318,051,983 21,577,370 3,607,526 0 343,236,879

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.

TAS funding represents funding contributions paid by Tasmania into its own state pool account, and subsequently paid to LHNs within the state, to the Tasmanian health department and/or to other state pool accounts.

Other state/territory funding represents contributions paid to Tasmania 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 – Tasmania, December 2013

This table shows funding paid into the Tasmania state managed fund by the Commonwealth and Tasmania, 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 4,277,742 4,277,742
State/territory Block funding 10,600,690 10,600,690
Total 14,878,431 14,878,431 0 14,878,431

See explanatory notes following table 2b.

Table 2b – State managed fund transactions YTD – Tasmania, December 2013

Following on from table 2a, this table shows year-to-date (YTD) funding paid into the Tasmanian state managed fund by the Commonwealth and Tasmania, and YTD payments out of the state managed fund to LHNs and other provider organisations as at December 2013.

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 21,577,370 21,577,370
State/territory Block funding 140,999,456 140,999,456
Total 162,576,826 162,576,826 0 162,576,826

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 Tasmanian 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 – Tasmania, December 2013

This table shows NHR funding and payments by service category on both a monthly and year-to-date (YTD) basis for Tasmania 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 30,299,452 30,299,452 185,120,662 185,120,662
Acute admitted - private 3,048,770 3,048,770 18,993,862 18,993,862
Non-admitted 10,510,918 10,510,918 64,605,663 64,605,663
Emergency department 6,012,496 6,012,496 36,521,423 36,521,423
Admitted mental health 0 0 0 0
Sub-acute 2,055,172 2,055,172 12,810,373 12,810,373
Total ABF (Pool) 51,926,808 51,926,808 318,051,983 318,051,983
Block
Non-admitted mental health 1,800,000 1,800,000 10,800,000 10,635,383
Small rural hospitals 3,750,962 3,750,962 22,439,896 22,826,967
Teaching, training & research 3,202,602 3,202,602 19,215,611 18,993,157
Other non-admitted services 6,124,867 6,124,867 110,121,318 110,121,318
Total Block (SMF) 14,878,431 14,878,431 162,576,826 162,576,826
Other
Public health funding 601,254 601,254 3,607,526 3,607,526
Overdeposit 0 0 0 0
Cross-border 0 0 0 0
Interest 5 0 2,365 0
Total Other (Pool) 601,259 601,254 3,609,891 3,607,526
Grand Total 67,406,499 67,406,494 484,238,699 484,236,334

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 – Tasmania, December 2013

This table shows NHR contributions (from state, territory and Commonwealth sources) made to each LHN in Tasmania 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)
($) ($) ($)
Tasmanian Health Organisation - North 17,078,878 3,454,624 20,533,502
Tasmanian Health Organisation - South 27,377,861 8,472,477 35,850,338
Tasmanian Health Service 7,470,069 2,951,331 10,421,400
Total 51,926,808 14,878,431 66,805,240

See explanatory notes below table 4b.

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

This table shows YTD NHR contributions (from state, territory and Commonwealth sources) made to each LHN in Tasmania 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)
($) ($) ($)
Tasmanian Health Organisation - North 106,749,902 51,388,225 158,138,127
Tasmanian Health Organisation - South 171,756,893 86,962,620 258,719,513
Tasmanian Health Service 39,545,188 24,225,980 63,771,169
Total 318,051,983 162,576,826 480,628,808

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 – Tasmania, 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 Tasmania.

Local hospital network (LHN) Estimated NWAU delivered in current month Estimated NWAU delivered YTD Estimated annual NWAU 2013-14
Tasmanian Health Organisation - North 3,887 24,005 47,904
Tasmanian Health Organisation - South 3,998 25,514 50,083
Tasmanian Health Service 1,292 7,935 16,091
Total 9,177 57,454 114,078

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.