Queensland report, March 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 Queensland for March 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 Queensland Department of Health to view the service agreement for that LHN.

Basis for National Health Reform payments – Queensland, March 2019

The basis used to determine NHR payments to LHNs in Queensland for March 2019 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, March 2019

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 March 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
340,140,557 340,140,557 340,140,557
Commonwealth
Block funding
38,555,765 38,555,765 38,555,765
Commonwealth
Other funding
6,798,428 6,798,428 6,798,428
Total C'wealth
funding
385,494,750 340,140,557 38,555,765 6,798,428 385,494,750
QLD
funding
479,189,974 475,960,072 0 3,200,000 479,160,072
Other state/territory funding 5,000,000 0 5,000,000 5,000,000
Total 869,684,723 816,100,629 38,555,765 11,798,428 3,200,000 869,654,821

See definitions and explanatory notes following table 1b.

Table 1b – State pool account transactions YTD – Queensland, March 2019

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 March 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
3,497,998,118 3,497,998,118 3,497,998,118
Commonwealth
Block funding
359,804,766 359,804,766 359,804,766
Commonwealth
Other funding
61,036,299 61,036,299 61,036,299
Total C'wealth
funding
3,918,839,183 3,497,998,118 359,804,766 61,036,299 3,918,839,183
QLD
funding
4,346,650,214 4,317,477,341 0 28,800,000 4,346,277,341
Other state/territory funding 45,000,000 0 45,000,000 45,000,000
Total 8,310,489,398 7,815,475,459 359,804,766 106,036,299 28,800,000 8,310,116,524

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, March 2019

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 March 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 38,555,765 38,555,765
State/territory Block funding 87,662,941 87,662,941
Total 126,218,705 126,218,705 0 126,218,705

See explanatory notes following table 2b.

Table 2b – State managed fund transactions YTD – Queensland, March 2019

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 March 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 359,804,766 359,804,766
State/territory Block funding 878,963,197 878,963,197
Total 1,238,767,963 1,238,767,963 0 1,238,767,963

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, March 2019

This table shows NHR funding and payments by service category on both a monthly and year-to-date (YTD) basis for Queensland for March 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 509,485,078 509,485,078 4,878,374,664 4,878,374,664
Admitted mental health 41,711,422 41,711,422 378,952,298 378,952,298
Sub-acute 47,257,710 47,257,710 431,189,065 431,189,065
Emergency department 105,901,793 105,901,793 1,024,559,434 1,024,559,434
Non-admitted 111,744,626 111,744,626 1,102,399,998 1,102,399,998
Total ABF (Pool) 816,100,629 816,100,629 7,815,475,459 7,815,475,459
Block
Small rural hospitals 61,162,672 61,162,672 592,923,337 592,923,337
Teaching, training & research 27,489,797 27,489,797 270,114,179 270,114,179
Non-admitted mental health 35,961,937 35,961,937 346,496,635 346,496,635
Other non-admitted services 1,604,299 1,604,299 29,233,813 29,233,813
Total Block (SMF) 126,218,705 126,218,705 1,238,767,963 1,238,767,963
Other
Public health funding 6,798,428 6,798,428 61,036,299 61,036,299
Overdeposit 0 0 0 0
Cross-border 8,200,000 8,200,000 73,800,000 73,800,000
Interest 29,902 0 372,874 0
Total Other (Pool) 15,028,330 14,998,428 135,209,172 134,836,299
Grand Total 957,347,664 957,317,762 9,189,452,595 9,189,079,721

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, March 2019

This table shows NHR contributions (from state, territory and Commonwealth sources) made to each LHN in Queensland during March 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)
($) ($) ($)
Cairns and Hinterland Hospital and Health Service 48,222,578 10,553,372 58,775,950
Central Queensland Hospital and Health Service 28,649,561 7,882,460 36,532,021
Central West Hospital and Health Service 0 3,646,543 3,646,543
Children's Health Queensland Hospital and Health Service 33,280,425 1,570,938 34,851,363
Darling Downs Hospital and Health Service 36,181,724 14,078,515 50,260,239
Gold Coast Hospital and Health Service 89,926,100 7,156,854 97,082,954
Mackay Hospital and Health Service 21,978,763 5,594,830 27,573,593
Mater Misericordiae Health Service Brisbane 31,842,255 988,308 32,830,563
Metro North Hospital and Health Service 171,690,394 14,027,119 185,717,513
Metro South Hospital and Health Service 146,464,370 13,144,859 159,609,229
North West Hospital and Health Service 7,199,116 2,806,004 10,005,120
Queensland Virtual LHN 6,343,150 0 6,343,150
South West Hospital and Health Service 0 5,796,481 5,796,481
Sunshine Coast Hospital and Health Service 74,889,350 5,295,802 80,185,152
Torres and Cape Hospital and Health Service 0 6,085,827 6,085,827
Townsville Hospital and Health Service 52,113,726 11,293,002 63,406,728
West Moreton Hospital and Health Service 31,408,667 11,444,755 42,853,422
Wide Bay Hospital and Health Service 32,726,221 4,754,207 37,480,428
Total 812,916,403 126,119,875 939,036,278

See explanatory notes below table 4b.

Table 4b – NHR contributions by local hospital network YTD – Queensland, March 2019

This table shows YTD NHR contributions (from state, territory and Commonwealth sources) made to each LHN in Queensland as at March 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)
($) ($) ($)
Cairns and Hinterland Hospital and Health Service 493,125,899 102,262,102 595,388,001
Central Queensland Hospital and Health Service 271,327,054 76,345,161 347,672,215
Central West Hospital and Health Service 0 35,296,470 35,296,470
Children's Health Queensland Hospital and Health Service 347,977,785 23,564,762 371,542,547
Darling Downs Hospital and Health Service 342,544,798 136,363,485 478,908,283
Gold Coast Hospital and Health Service 873,301,224 70,171,470 943,472,694
Mackay Hospital and Health Service 210,577,856 54,252,319 264,830,175
Mater Misericordiae Health Service Brisbane 331,938,763 9,711,095 341,649,858
Metro North Hospital and Health Service 1,596,495,062 139,538,277 1,736,033,339
Metro South Hospital and Health Service 1,389,840,876 129,644,155 1,519,485,031
North West Hospital and Health Service 63,355,043 27,189,429 90,544,472
Queensland Virtual LHN 50,368,086 0 50,368,086
South West Hospital and Health Service 0 56,102,340 56,102,340
Sunshine Coast Hospital and Health Service 679,324,845 51,991,426 731,316,271
Torres and Cape Hospital and Health Service 0 58,895,709 58,895,709
Townsville Hospital and Health Service 493,569,848 109,529,846 603,099,694
West Moreton Hospital and Health Service 293,529,823 110,854,071 404,383,894
Wide Bay Hospital and Health Service 345,004,622 46,084,737 391,089,358
Total 7,782,281,583 1,237,796,854 9,020,078,437

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, March 2019

This table shows estimated state or territory hospital activity for activity-based funding services expressed as NWAU for March 2019, 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 88,523 118,030
Central Queensland Hospital and Health Service 5,308 47,768 63,691
Children's Health Queensland Hospital and Health Service 6,504 58,536 78,048
Darling Downs Hospital and Health Service 6,763 60,870 81,160
Gold Coast Hospital and Health Service 17,632 158,688 211,585
Mackay Hospital and Health Service 4,276 38,484 51,312
Mater Misericordiae Health Service Brisbane 7,052 63,464 84,618
Metro North Hospital and Health Service 32,999 296,990 395,986
Metro South Hospital and Health Service 26,477 238,293 317,724
North West Hospital and Health Service 1,160 10,444 13,925
Queensland Virtual LHN 2,222 19,996 26,661
Sunshine Coast Hospital and Health Service 12,159 109,430 145,907
Townsville Hospital and Health Service 10,127 91,143 121,524
West Moreton Hospital and Health Service 6,075 54,672 72,895
Wide Bay Hospital and Health Service 6,911 62,200 82,933
Total 155,500 1,399,500 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.