South Australian report, April 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 South Australia for April 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 SA Department of Health to view the service agreement for that LHN.

Basis for National Health Reform payments – South Australia, April 2019

The basis used to determine NHR payments to LHNs in South Australia for April 2019 was advised by the SA Department of Health to be as follows:

In determining the annual funding allocation for all LHNs, the budget has been built up predominantly on an activity basis that shares principles with the IHPA framework. It is designed to equitably distribute funding to each LHN relative to all LHNs in South Australia. This occurs within the confines of a limited funding pool that includes adjustments to recognise cost improvements and the attainment of service efficiencies that are also equitably allocated on an activity basis. Supplementation is provided as block funding where an activity-based approach is not appropriate. This captures the provision of services including teaching, training and research, some mental health services and the delivery of out of hospital strategies incorporating primary health.

Monthly allocations to LHNs will vary for a variety of reasons, but they are predominantly cash flow financed based on need which includes the activity demand on hospital services.

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 – South Australia, April 2019

This table shows funding paid into the South Australian state pool account by the Commonwealth, South Australia or other states/territories, and payments out of the state pool account to LHNs, the state managed fund, the SA Department of Health or the state pool accounts of other states/territories for April 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
101,186,230 101,186,230 101,186,230
Commonwealth
Block funding
15,085,370 15,085,370 15,085,370
Commonwealth
Other funding
2,199,481 2,199,481 2,199,481
Total C'wealth
funding
118,471,081 101,186,230 15,085,370 2,199,481 118,471,081
SA
funding
154,471,703 182,552,406 0 0 182,552,406
Other state/territory funding 0 0 0 0
Total 272,942,783 283,738,636 15,085,370 2,199,481 0 301,023,486

See definitions and explanatory notes following table 1b.

Table 1b – State pool account transactions YTD – South Australia, April 2019

Following on from table 1a, this table shows year-to-date (YTD) funding paid into the South Australian state pool account by the Commonwealth, South Australia or other states/territories, and payments out of the state pool account to LHNs, the state managed fund, the SA Department of Health or the state pool accounts of other states/territories as at April 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
920,221,117 920,221,117 920,221,117
Commonwealth
Block funding
151,764,133 151,764,133 151,764,133
Commonwealth
Other funding
23,217,120 23,217,120 23,217,120
Total C'wealth
funding
1,095,202,369 920,221,117 151,764,133 23,217,120 1,095,202,369
SA
funding
2,054,792,710 1,677,570,829 0 0 1,677,570,829
Other state/territory funding 0 0 0 0
Total 3,149,995,079 2,597,791,945 151,764,133 23,217,120 0 2,772,773,198

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.

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

Other state/territory funding represents contributions paid to South Australia 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 – South Australia, April 2019

This table shows funding paid into the South Australia state managed fund by the Commonwealth and South Australia, and payments out of the state managed fund to LHNs and other provider organisations for April 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 15,085,370 15,085,370
State/territory Block funding 27,191,912 27,191,912
Total 42,277,281 42,277,281 0 42,277,281

See explanatory notes following table 2b.

Table 2b – State managed fund transactions YTD – South Australia, April 2019

Following on from table 2a, this table shows year-to-date (YTD) funding paid into the South Australian state managed fund by the Commonwealth and South Australia, and YTD payments out of the state managed fund to LHNs and other provider organisations as at April 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 151,764,133 151,764,133
State/territory Block funding 162,003,091 162,003,091
Total 313,767,224 313,767,224 0 313,767,224

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 South Australian 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 – South Australia, April 2019

This table shows NHR funding and payments by service category on both a monthly and year-to-date (YTD) basis for South Australia for April 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 155,923,299 172,745,995 1,810,835,223 1,582,778,478
Admitted mental health 18,567,805 20,500,372 213,774,454 187,196,861
Sub-acute 14,507,927 16,042,120 165,960,433 145,210,411
Emergency department 30,787,179 34,258,962 358,666,715 312,326,007
Non-admitted 35,400,019 40,191,187 422,984,291 370,280,189
Total ABF (Pool) 255,186,230 283,738,636 2,972,221,117 2,597,791,945
Block
Small rural hospitals 19,010,339 19,010,339 155,487,111 155,487,111
Teaching, training & research 7,820,370 7,820,370 53,136,227 53,136,227
Non-admitted mental health 12,987,871 12,987,871 79,906,119 79,906,119
Other non-admitted services 2,458,701 2,458,701 25,237,767 25,237,767
Total Block (SMF) 42,277,281 42,277,281 313,767,224 313,767,224
Other
Public health funding 2,199,481 2,199,481 23,217,120 23,217,120
Overdeposit 0 0 0 0
Cross-border 0 0 0 0
Interest 471,703 2,792,710 0
Total Other (Pool) 2,671,184 2,199,481 26,009,829 23,217,120
Grand Total 300,134,695 328,215,398 3,311,998,171 2,934,776,289

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 – South Australia, April 2019

This table shows NHR contributions (from state, territory and Commonwealth sources) made to each LHN in South Australia during April 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)
($) ($) ($)
Central Adelaide Local Health Network 93,407,403 6,392,597 99,800,000
Central Office Services 2,315,917 0 2,315,917
Country Health SA Local Health Network 35,088,021 23,011,979 58,100,000
Northern Adelaide Local Health Network 50,093,221 9,606,779 59,700,000
Southern Adelaide Local Health Network 78,642,228 2,157,772 80,800,000
Women's and Children's Health Network 24,191,846 1,108,154 25,300,000
Total 283,738,636 42,277,281 326,015,917

See explanatory notes below table 4b.

Table 4b – NHR contributions by local hospital network YTD – South Australia, April 2019

This table shows YTD NHR contributions (from state, territory and Commonwealth sources) made to each LHN in South Australia as at April 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)
($) ($) ($)
Central Adelaide Local Health Network 890,084,243 63,715,757 953,800,000
Central Office Services 23,159,170 0 23,159,170
Country Health SA Local Health Network 325,883,151 188,216,849 514,100,000
Northern Adelaide Local Health Network 449,626,790 26,173,210 475,800,000
Southern Adelaide Local Health Network 665,192,353 21,707,647 686,900,000
Women's and Children's Health Network 243,846,238 13,953,762 257,800,000
Total 2,597,791,945 313,767,224 2,911,559,170

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 – South Australia, April 2019

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

Local hospital network (LHN) Estimated NWAU delivered in current month Estimated NWAU delivered YTD Estimated annual NWAU 2018-19
Central Adelaide Local Health Network 18,046 171,964 203,838
Central Office Services 447 4,474 5,369
Country Health SA Local Health Network 6,779 62,960 70,633
Northern Adelaide Local Health Network 9,678 86,868 100,863
Southern Adelaide Local Health Network 15,194 128,515 157,851
Women's and Children's Health Network 4,674 47,111 56,517
Total 54,818 501,892 595,071

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.