Queensland report, August 2018

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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 Queensland for August 2018 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 Queensland Department of Health to view the service agreement for that LHN.

Basis for National Health Reform payments – Queensland, August 2018

The basis used to determine NHR payments to LHNs in Queensland for August 2018 was advised by the Queensland Department of Health to be as follows:

Service agreements between the Department of Health and each Hospital and Health Service (HHS) are based on the Department’s funding and purchasing models. In broad terms, the funding model determines the price at which the department purchases services from HHSs, and the purchasing model determines the volume of services that are purchased.

In terms of the funding model:

36 of the largest public hospitals are funded through the Queensland Activity Based Funding (ABF) model, which sets prices at a disaggregated level for each type of public hospital service. The Queensland ABF model is based largely on the national ABF model, but includes a number of modifications to reflect Queensland priorities.

83 public hospitals, predominantly small regional and rural hospitals, and 4 specialist mental health facilities are funded through block funding arrangements which take account of hospital size and location. These are based on 2017-18 reported expenditure (net of depreciation) indexed to 2018-19 levels.

Most non-hospital services (e.g. preventive health, primary and community health) are funded based on historical funding levels. However, some services, such as oral health and breast screening, are funded based on a price per unit of output.

The purchasing model determines the volume and value of services that the Department agrees to purchase from each HHS through the service agreement. The model reflects key priority areas for investment which is informed through a range of planning models, growth projections and performance objectives for each HHS.

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 – Queensland, August 2018

This table shows funding paid into the Queensland state pool account by the Commonwealth, Queensland or other states/territories, and payments out of the state pool account to LHNs, the state managed fund, the Queensland Department of Health or the state pool accounts of other states/territories for August 2018.

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
305,531,876 305,531,876 305,531,876
Commonwealth
Block funding
38,555,765 38,555,765 38,555,765
Commonwealth
Other funding
6,797,179 6,797,179 6,797,179
Total C'wealth
funding
350,884,819 305,531,876 38,555,765 6,797,179 350,884,819
QLD
funding
518,736,751 515,499,243 0 3,200,000 518,699,243
Other state/territory funding 5,000,000 0 5,000,000 5,000,000
Total 874,621,571 821,031,119 38,555,765 11,797,179 3,200,000 874,584,063

See definitions and explanatory notes following table 1b.

Table 1b – State pool account transactions YTD – Queensland, August 2018

Following on from table 1a, this table shows year-to-date (YTD) funding paid into the Queensland state pool account by the Commonwealth, Queensland or other states/territories, and payments out of the state pool account to LHNs, the state managed fund, the Queensland Department of Health or the state pool accounts of other states/territories as at August 2018.

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
611,063,752 611,063,752 611,063,752
Commonwealth
Block funding
77,111,529 77,111,529 77,111,529
Commonwealth
Other funding
13,594,358 13,594,358 13,594,358
Total C'wealth
funding
701,769,639 611,063,752 77,111,529 13,594,358 701,769,639
QLD
funding
1,190,106,038 1,183,634,397 0 6,400,000 1,190,034,397
Other state/territory funding 10,000,000 0 10,000,000 10,000,000
Total 1,901,875,677 1,794,698,149 77,111,529 23,594,358 6,400,000 1,901,804,036

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.

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

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

Note: The grey shaded areas in these tables reflect cells that are not applicable for a particular 'paid out' column. For example, Commonwealth block funding is only paid to state managed funds and not to local hospital networks or state or territory health departments.

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

State managed fund transactions

Table 2a – State managed fund transactions – Queensland, August 2018

This table shows funding paid into the Queensland state managed fund by the Commonwealth and Queensland, and payments out of the state managed fund to LHNs and other provider organisations for August 2018.

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 38,555,765 38,555,765
State/territory Block funding 100,347,655 100,347,655
Total 138,903,420 138,903,420 0 138,903,420

See explanatory notes following table 2b.

Table 2b – State managed fund transactions YTD – Queensland, August 2018

Following on from table 2a, this table shows year-to-date (YTD) funding paid into the Queensland state managed fund by the Commonwealth and Queensland, and YTD payments out of the state managed fund to LHNs and other provider organisations as at August 2018.

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 77,111,529 77,111,529
State/territory Block funding 217,509,918 217,509,918
Total 294,621,447 294,621,447 0 294,621,447

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 Queensland 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 – Queensland, August 2018

This table shows NHR funding and payments by service category on both a monthly and year-to-date (YTD) basis for Queensland for August 2018. 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 511,295,755 511,295,755 1,118,288,892 1,118,288,892
Admitted mental health 36,254,259 36,254,259 78,969,980 78,969,980
Sub-acute 41,310,676 41,310,676 90,341,833 90,341,833
Emergency department 110,473,969 110,473,969 241,189,679 241,189,679
Non-admitted 121,696,460 121,696,460 265,907,765 265,907,765
Total ABF (Pool) 821,031,119 821,031,119 1,794,698,149 1,794,698,149
Block
Small rural hospitals 69,421,992 69,421,992 141,402,293 141,402,293
Teaching, training & research 29,596,045 29,596,045 65,850,519 65,850,519
Non-admitted mental health 37,964,984 37,964,984 82,843,135 82,843,135
Other non-admitted services 1,920,400 1,920,400 4,525,499 4,525,499
Total Block (SMF) 138,903,420 138,903,420 294,621,447 294,621,447
Other
Public health funding 6,797,179 6,797,179 13,594,358 13,594,358
Overdeposit 0 0 0 0
Cross-border 8,200,000 8,200,000 16,400,000 16,400,000
Interest 37,508 0 71,640 0
Total Other (Pool) 15,034,687 14,997,179 30,065,998 29,994,358
Grand Total 974,969,226 974,931,718 2,119,385,595 2,119,313,954

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 – Queensland, August 2018

This table shows NHR contributions (from state, territory and Commonwealth sources) made to each LHN in Queensland during August 2018.

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)
($) ($) ($)
Cairns and Hinterland Hospital and Health Service 54,761,451 13,054,959 67,816,411
Central Queensland Hospital and Health Service 29,639,371 9,096,984 38,736,355
Central West Hospital and Health Service 0 5,074,943 5,074,943
Children's Health Queensland Hospital and Health Service 36,347,894 2,394,852 38,742,746
Darling Downs Hospital and Health Service 42,211,772 16,270,934 58,482,706
Gold Coast Hospital and Health Service 82,170,860 6,741,286 88,912,146
Mackay Hospital and Health Service 23,308,341 6,694,755 30,003,095
Mater Misericordiae Health Service Brisbane 34,621,415 1,141,599 35,763,014
Metro North Hospital and Health Service 174,262,757 15,588,626 189,851,382
Metro South Hospital and Health Service 146,645,948 12,490,135 159,136,083
North West Hospital and Health Service 5,724,323 2,594,008 8,318,332
Queensland Virtual LHN 1,913,596 0 1,913,596
South West Hospital and Health Service 0 6,438,149 6,438,149
Sunshine Coast Hospital and Health Service 68,533,764 6,001,622 74,535,386
Torres and Cape Hospital and Health Service 0 6,468,256 6,468,256
Townsville Hospital and Health Service 52,969,084 13,435,271 66,404,356
West Moreton Hospital and Health Service 27,773,577 10,068,659 37,842,236
Wide Bay Hospital and Health Service 36,684,825 5,234,221 41,919,046
Total 817,568,978 138,789,260 956,358,238

See explanatory notes below table 4b.

Table 4b – NHR contributions by local hospital network YTD – Queensland, August 2018

This table shows YTD NHR contributions (from state, territory and Commonwealth sources) made to each LHN in Queensland as at August 2018.

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)
($) ($) ($)
Cairns and Hinterland Hospital and Health Service 115,295,622 24,747,613 140,043,235
Central Queensland Hospital and Health Service 62,751,979 18,466,430 81,218,409
Central West Hospital and Health Service 0 8,531,882 8,531,882
Children's Health Queensland Hospital and Health Service 81,859,412 5,285,244 87,144,656
Darling Downs Hospital and Health Service 78,948,069 32,985,464 111,933,533
Gold Coast Hospital and Health Service 188,713,598 15,845,672 204,559,270
Mackay Hospital and Health Service 48,131,151 13,139,087 61,270,237
Mater Misericordiae Health Service Brisbane 76,516,426 2,384,764 78,901,190
Metro North Hospital and Health Service 377,264,275 33,670,843 410,935,118
Metro South Hospital and Health Service 322,162,955 31,312,844 353,475,799
North West Hospital and Health Service 14,701,793 6,579,705 21,281,498
Queensland Virtual LHN 3,827,192 0 3,827,192
South West Hospital and Health Service 0 13,559,969 13,559,969
Sunshine Coast Hospital and Health Service 157,813,644 12,576,017 170,389,660
Torres and Cape Hospital and Health Service 0 14,233,288 14,233,288
Townsville Hospital and Health Service 115,909,113 26,532,413 142,441,526
West Moreton Hospital and Health Service 63,482,751 23,374,887 86,857,639
Wide Bay Hospital and Health Service 79,668,527 11,156,848 90,825,375
Total 1,787,046,507 294,382,971 2,081,429,477

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 – Queensland, August 2018

This table shows estimated state or territory hospital activity for activity-based funding services expressed as NWAU for August 2018, the associated cumulative year-to-date (YTD), and total estimated annual NWAU for each LHN in Queensland.

Local hospital network (LHN) Estimated NWAU delivered in current month Estimated NWAU delivered YTD Estimated annual NWAU 2018-19
Cairns and Hinterland Hospital and Health Service 9,943 19,885 119,310
Central Queensland Hospital and Health Service 5,329 10,658 63,946
Children's Health Queensland Hospital and Health Service 6,602 13,204 79,226
Darling Downs Hospital and Health Service 6,746 13,493 80,957
Gold Coast Hospital and Health Service 17,063 34,126 204,758
Mackay Hospital and Health Service 4,342 8,684 52,104
Mater Misericordiae Health Service Brisbane 7,292 14,584 87,506
Metro North Hospital and Health Service 33,317 66,634 399,804
Metro South Hospital and Health Service 27,002 54,004 324,021
North West Hospital and Health Service 1,072 2,144 12,862
Queensland Virtual LHN 896 1,791 10,747
Sunshine Coast Hospital and Health Service 12,550 25,100 150,600
Townsville Hospital and Health Service 10,225 20,450 122,701
West Moreton Hospital and Health Service 6,112 12,225 73,348
Wide Bay Hospital and Health Service 7,009 14,018 84,109
Total 155,500 311,000 1,866,000

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.