Queensland report, December 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 December 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, December 2018

The basis used to determine NHR payments to LHNs in Queensland for December 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, December 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 December 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
520,326,940 520,326,940 520,326,940
Commonwealth
Block funding
42,823,393 42,823,393 42,823,393
Commonwealth
Other funding
6,749,825 6,749,825 6,749,825
Total C'wealth
funding
569,900,159 520,326,940 42,823,393 6,749,825 569,900,159
QLD
funding
410,479,051 407,243,673 0 3,200,000 410,443,673
Other state/territory funding 5,000,000 0 5,000,000 5,000,000
Total 985,379,210 927,570,613 42,823,393 11,749,825 3,200,000 985,343,832

See definitions and explanatory notes following table 1b.

Table 1b – State pool account transactions YTD – Queensland, December 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 December 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
2,477,576,448 2,477,576,448 2,477,576,448
Commonwealth
Block funding
244,137,473 244,137,473 244,137,473
Commonwealth
Other funding
40,641,013 40,641,013 40,641,013
Total C'wealth
funding
2,762,354,935 2,477,576,448 244,137,473 40,641,013 2,762,354,935
QLD
funding
2,749,566,450 2,730,139,339 0 19,200,000 2,749,339,339
Other state/territory funding 30,000,000 0 30,000,000 30,000,000
Total 5,541,921,384 5,207,715,788 244,137,473 70,641,013 19,200,000 5,541,694,274

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, December 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 December 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 42,823,393 42,823,393
State/territory Block funding 95,231,509 95,231,509
Total 138,054,903 138,054,903 0 138,054,903

See explanatory notes following table 2b.

Table 2b – State managed fund transactions YTD – Queensland, December 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 December 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 244,137,473 244,137,473
State/territory Block funding 572,151,503 572,151,503
Total 816,288,976 816,288,976 0 816,288,976

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, December 2018

This table shows NHR funding and payments by service category on both a monthly and year-to-date (YTD) basis for Queensland for December 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 578,957,696 578,957,696 3,248,931,907 3,248,931,907
Admitted mental health 47,005,444 47,005,444 246,141,357 246,141,357
Sub-acute 53,346,011 53,346,011 280,467,232 280,467,232
Emergency department 120,328,137 120,328,137 686,476,161 686,476,161
Non-admitted 127,933,326 127,933,326 745,699,131 745,699,131
Total ABF (Pool) 927,570,613 927,570,613 5,207,715,788 5,207,715,788
Block
Small rural hospitals 66,560,324 66,560,324 388,756,541 388,756,541
Teaching, training & research 28,303,243 28,303,243 176,291,790 176,291,790
Non-admitted mental health 37,319,409 37,319,409 227,191,231 227,191,231
Other non-admitted services 5,871,927 5,871,927 24,049,414 24,049,414
Total Block (SMF) 138,054,903 138,054,903 816,288,976 816,288,976
Other
Public health funding 6,749,825 6,749,825 40,641,013 40,641,013
Overdeposit 0 0 0 0
Cross-border 8,200,000 8,200,000 49,200,000 49,200,000
Interest 35,378 0 227,110 0
Total Other (Pool) 14,985,203 14,949,825 90,068,124 89,841,013
Grand Total 1,080,610,719 1,080,575,341 6,114,072,888 6,113,845,777

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, December 2018

This table shows NHR contributions (from state, territory and Commonwealth sources) made to each LHN in Queensland during December 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 63,536,469 10,553,372 74,089,841
Central Queensland Hospital and Health Service 34,099,834 7,882,460 41,982,294
Central West Hospital and Health Service 0 3,646,543 3,646,543
Children's Health Queensland Hospital and Health Service 44,581,674 3,619,987 48,201,661
Darling Downs Hospital and Health Service 42,904,357 14,078,515 56,982,872
Gold Coast Hospital and Health Service 106,257,622 7,362,864 113,620,486
Mackay Hospital and Health Service 26,577,917 5,594,830 32,172,747
Mater Misericordiae Health Service Brisbane 39,766,554 988,319 40,754,873
Metro North Hospital and Health Service 179,361,016 15,143,488 194,504,504
Metro South Hospital and Health Service 163,877,174 13,845,864 177,723,038
North West Hospital and Health Service 7,421,815 2,806,004 10,227,818
Queensland Virtual LHN 8,532,616 0 8,532,616
South West Hospital and Health Service 0 5,796,481 5,796,481
Sunshine Coast Hospital and Health Service 75,220,405 5,490,996 80,711,401
Torres and Cape Hospital and Health Service 0 6,085,827 6,085,827
Townsville Hospital and Health Service 59,882,930 11,293,002 71,175,932
West Moreton Hospital and Health Service 27,373,098 19,013,312 46,386,410
Wide Bay Hospital and Health Service 44,200,480 4,754,207 48,954,686
Total 923,593,958 137,956,071 1,061,550,029

See explanatory notes below table 4b.

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

This table shows YTD NHR contributions (from state, territory and Commonwealth sources) made to each LHN in Queensland as at December 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 339,048,485 66,961,101 406,009,586
Central Queensland Hospital and Health Service 182,394,347 49,996,268 232,390,615
Central West Hospital and Health Service 0 23,118,055 23,118,055
Children's Health Queensland Hospital and Health Service 236,618,336 18,387,839 255,006,176
Darling Downs Hospital and Health Service 229,632,717 89,299,523 318,932,240
Gold Coast Hospital and Health Service 575,528,006 46,130,030 621,658,035
Mackay Hospital and Health Service 142,656,180 35,518,407 178,174,586
Mater Misericordiae Health Service Brisbane 227,455,920 6,338,008 233,793,928
Metro North Hospital and Health Service 1,047,655,800 92,484,371 1,140,140,171
Metro South Hospital and Health Service 928,079,427 85,590,886 1,013,670,312
North West Hospital and Health Service 40,111,705 17,803,720 57,915,424
Queensland Virtual LHN 31,338,635 0 31,338,635
South West Hospital and Health Service 0 36,745,893 36,745,893
Sunshine Coast Hospital and Health Service 444,016,901 34,232,207 478,249,108
Torres and Cape Hospital and Health Service 0 38,576,595 38,576,595
Townsville Hospital and Health Service 328,954,837 71,704,422 400,659,258
West Moreton Hospital and Health Service 196,092,843 72,594,176 268,687,019
Wide Bay Hospital and Health Service 235,386,058 30,173,675 265,559,734
Total 5,184,970,196 815,655,175 6,000,625,371

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, December 2018

This table shows estimated state or territory hospital activity for activity-based funding services expressed as NWAU for December 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 9,836 59,015 118,030
Central Queensland Hospital and Health Service 5,308 31,845 63,691
Children's Health Queensland Hospital and Health Service 6,504 39,024 78,048
Darling Downs Hospital and Health Service 6,763 40,580 81,160
Gold Coast Hospital and Health Service 17,632 105,792 211,585
Mackay Hospital and Health Service 4,276 25,656 51,312
Mater Misericordiae Health Service Brisbane 7,052 42,309 84,618
Metro North Hospital and Health Service 32,999 197,993 395,986
Metro South Hospital and Health Service 26,477 158,862 317,724
North West Hospital and Health Service 1,160 6,963 13,925
Queensland Virtual LHN 2,222 13,331 26,661
Sunshine Coast Hospital and Health Service 12,159 72,953 145,907
Townsville Hospital and Health Service 10,127 60,762 121,524
West Moreton Hospital and Health Service 6,075 36,448 72,895
Wide Bay Hospital and Health Service 6,911 41,466 82,933
Total 155,500 933,000 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.