Australian Capital Territory report, February 2019

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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 the Australian Capital Territory for February 2019 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 ACT Health Directorate to view the service agreement for that LHN.

Basis for National Health Reform payments – Australian Capital Territory, February 2019

The basis used to determine NHR payments to the Australian Capital Territory Local Hospital Network (LHN) for February 2019 was advised by the ACT Health Directorate to be as follows:

The annual funding allocation for the ACT in 2018-19 is based on budget-neutral modelling. This modelling is predicated on the historical cost of providing hospital services plus wages and non-wages indexation. The activity for activity-based funded services is derived using historical activity levels plus an allowance for reasonable growth in public hospital services for the current year. The weighted activity is measured and funded based on the full Independent Hospital Pricing Authority pricing model and framework parameters.

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 – Australian Capital Territory, February 2019

This table shows funding paid into the Australian Capital Territory state pool account by the Commonwealth, the Australian Capital Territory or other states/territories, and payments out of the state pool account to LHNs, the state managed fund, the ACT Health Directorate or the state pool accounts of other states/territories for February 2019.

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
29,382,613 29,382,613 29,382,613
Commonwealth
Block funding
2,266,093 2,266,093 2,266,093
Commonwealth
Other funding
566,453 566,453 566,453
Total C'wealth
funding
32,215,160 29,382,613 2,266,093 566,453 32,215,160
ACT
funding
45,584,000 52,194,000 0 1,650,000 53,844,000
Other state/territory funding 8,260,000 0 0 8,260,000 8,260,000
Total 86,059,160 81,576,613 2,266,093 566,453 1,650,000 86,059,160

See definitions and explanatory notes following table 1b.

Table 1b – State pool account transactions YTD – Australian Capital Territory, February 2019

Following on from table 1a, this table shows year-to-date (YTD) funding paid into the Australian Capital Territory state pool account by the Commonwealth, the Australian Capital Territory or other states/territories, and payments out of the state pool account to LHNs, the state managed fund, the ACT Health Directorate or the state pool accounts of other states/territories as at February 2019.

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
249,612,606 249,612,606 249,612,606
Commonwealth
Block funding
19,228,006 19,228,006 19,228,006
Commonwealth
Other funding
4,652,376 4,652,376 4,652,376
Total C'wealth
funding
273,492,987 249,612,606 19,228,006 4,652,376 273,492,987
ACT
funding
387,464,000 440,344,000 0 13,200,000 453,544,000
Other state/territory funding 66,080,000 0 0 0
Total 727,036,988 689,956,606 19,228,006 4,652,376 13,200,000 727,036,987

Commonwealth ABF funding represents Acute admitted, Non-admitted, 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.

ACT funding represents funding contributions paid by the Australian Capital Territory into its own state pool account, and subsequently paid to LHNs within the territory, to the Australian Capital Territory health department and/or to other state pool accounts.

Other state/territory funding represents contributions paid to the Australian Capital Territory 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 health departments.

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

State managed fund transactions

Table 2a – State managed fund transactions – Australian Capital Territory, February 2019

This table shows funding paid into the Australian Capital Territory state managed fund by the Commonwealth and the Australian Capital Territory, and payments out of the state managed fund to LHNs and other provider organisations for February 2019.

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 2,266,093 2,266,093
State/territory Block funding 5,954,000 5,954,000
Total 8,220,093 8,220,093 0 8,220,093

See explanatory notes following table 2b.

Table 2b – State managed fund transactions YTD – Australian Capital Territory, February 2019

Following on from table 2a, this table shows year-to-date (YTD) funding paid into the Australian Capital Territory state managed fund by the Commonwealth and the Australian Capital Territory, and YTD payments out of the state managed fund to LHNs and other provider organisations as at February 2019.

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 19,228,006 19,228,006
State/territory Block funding 50,609,000 50,609,000
Total 69,837,006 69,837,006 0 69,837,006

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 Australian Capital Territory 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.

NHR funding and payments by service category

Table 3 – NHR funding and payments by service category – Australian Capital Territory, February 2019

This table shows NHR funding and payments by service category on both a monthly and year-to-date (YTD) basis for the Australian Capital Territory for February 2019. 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 47,055,187 52,356,521 400,408,980 442,819,651
Admitted mental health 3,895,972 4,334,900 33,152,179 36,663,605
Sub-acute 4,677,661 5,204,655 39,803,844 44,019,803
Emergency department 8,730,247 9,713,815 74,288,715 82,157,256
Non-admitted 8,957,547 9,966,722 76,222,887 84,296,292
Total ABF (Pool) 73,316,613 81,576,613 623,876,606 689,956,606
Block
Small rural hospitals 298,353 282,821 2,489,255 2,402,819
Teaching, training & research 3,858,148 4,589,082 32,527,170 38,988,337
Non-admitted mental health 3,946,460 3,251,164 32,749,125 27,621,527
Other non-admitted services 117,132 97,026 2,071,457 824,323
Total Block (SMF) 8,220,093 8,220,093 69,837,006 69,837,006
Other
Public health funding 566,453 566,453 4,652,376 4,652,376
Overdeposit 0 0 0 0
Cross-border 9,910,000 1,650,000 79,280,000 13,200,000
Interest 0 0 0 0
Total Other (Pool) 10,476,453 2,216,453 83,932,376 17,852,376
Grand Total 92,013,160 92,013,160 777,645,988 777,645,987

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 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.

NHR contributions by local hospital network

Table 4a – NHR contributions by local hospital network – Australian Capital Territory, February 2019

This table shows NHR contributions (from state, territory and Commonwealth sources) made to each LHN in the Australian Capital Territory during February 2019.

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)
($) ($) ($)
ACT Local Hospital Network Directorate 81,576,613 8,220,093 89,796,707
Total 81,576,613 8,220,093 89,796,707

See explanatory notes below table 4b.

Table 4b – NHR contributions by local hospital network YTD – Australian Capital Territory, February 2019

This table shows YTD NHR contributions (from state, territory and Commonwealth sources) made to each LHN in the Australian Capital Territory as at February 2019.

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)
($) ($) ($)
ACT Local Hospital Network Directorate 689,956,606 69,837,006 759,793,612
Total 689,956,606 69,837,006 759,793,612

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.

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 – Australian Capital Territory, February 2019

This table shows estimated state or territory hospital activity for activity-based funding services expressed as NWAU for February 2019, the associated cumulative year-to-date (YTD), and total estimated annual NWAU for each LHN in the Australian Capital Territory.

Local hospital network (LHN) Estimated NWAU delivered in current month Estimated NWAU delivered YTD Estimated annual NWAU 2018-19
ACT Local Hospital Network Directorate 12,403 99,902 158,697
Total 12,403 99,902 158,697

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.