Tasmanian 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 Tasmania 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 Tasmanian Department of Health and Human Services to view the service agreement for that LHN.

Basis for National Health Reform payments – Tasmania, March 2019

The basis used to determine NHR payments to LHNs in Tasmania for March 2019 was advised by the Tasmanian Department of Health and Human Services to be as follows:

NHR payments in Tasmania are based upon the activity outlined in the annual service agreement between the Minister for Health and the Tasmanian Health Service (THS).

The service agreement is informed by the Statement of Purchaser Intent (SOPI) and includes:

  • a schedule of services to be provided by or on behalf of the THS and the funding to be provided in relation to the provision of those services;
  • performance standards, performance targets and performance measures for the THS, and
  • standards of patient care and service delivery.

Acute admitted and sub and non-acute service activity volumes are modelled based on age adjusted, population growth and other known factors using historical activity data. Emergency Department and outpatient service volumes are modelled based on agreed growth rates and other known historical data factors.

To provide consistency in methodology and consistency with the National Health Reform Agreement (NHRA), the 2018-19 Tasmanian Funding Model has adopted the National Weighted Activity Unit (NWAU) as the currency for Activity Based Funding, with the applicable version being NWAU18, and National Efficient Cost (NEC18), with some modifications in relation to small regional and remote hospitals, stand - alone hospitals providing specialist Mental Health services (admitted and non-admitted), and teaching, training and research.

The 2018-19 Tasmanian Funding Model also provides funding via operational and block grants to the THS covering services provided and activities undertaken that are not within scope for ABF.

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 – Tasmania, March 2019

This table shows funding paid into the Tasmanian state pool account by the Commonwealth, Tasmania or other states/territories, and payments out of the state pool account to LHNs, the state managed fund, the Tasmanian Department of Health and Human Services 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
29,373,653 29,373,653 29,373,653
Commonwealth
Block funding
5,588,884 5,588,884 5,588,884
Commonwealth
Other funding
708,476 708,476 708,476
Total C'wealth
funding
35,671,013 29,373,653 5,588,884 708,476 35,671,013
TAS
funding
32,069,905 31,504,580 0 565,326 32,069,905
Other state/territory funding 260,382 0 260,382 260,382
Total 68,001,300 60,878,232 5,588,884 968,858 565,326 68,001,300

See definitions and explanatory notes following table 1b.

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

Following on from table 1a, this table shows year-to-date (YTD) funding paid into the Tasmanian state pool account by the Commonwealth, Tasmania or other states/territories, and payments out of the state pool account to LHNs, the state managed fund, the Tasmanian Department of Health and Human Services 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
266,467,027 266,467,027 266,467,027
Commonwealth
Block funding
52,499,457 52,499,457 52,499,457
Commonwealth
Other funding
6,358,252 6,358,252 6,358,252
Total C'wealth
funding
325,324,735 266,467,027 52,499,457 6,358,252 325,324,735
TAS
funding
297,857,883 297,287,329 5,228 565,326 297,857,883
Other state/territory funding 260,382 0 260,382 260,382
Total 623,443,000 563,754,356 52,499,457 6,623,862 565,326 623,443,000

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.

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

Other state/territory funding represents contributions paid to Tasmania 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 – Tasmania, March 2019

This table shows funding paid into the Tasmania state managed fund by the Commonwealth and Tasmania, 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 5,588,884 5,588,884
State/territory Block funding 21,500,000 21,500,000
Total 27,088,884 27,088,884 0 27,088,884

See explanatory notes following table 2b.

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

Following on from table 2a, this table shows year-to-date (YTD) funding paid into the Tasmanian state managed fund by the Commonwealth and Tasmania, 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 52,499,457 52,499,457
State/territory Block funding 289,936,568 289,936,568
Total 342,436,024 342,436,024 0 342,436,024

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 Tasmanian 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 – Tasmania, March 2019

This table shows NHR funding and payments by service category on both a monthly and year-to-date (YTD) basis for Tasmania 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 40,452,604 40,452,604 376,671,810 376,671,810
Admitted mental health 2,729,404 2,729,404 22,890,367 22,890,367
Sub-acute 2,620,694 2,620,694 25,429,555 25,429,555
Emergency department 7,680,558 7,680,558 71,796,644 71,796,644
Non-admitted 7,394,972 7,394,972 66,965,979 66,965,979
Total ABF (Pool) 60,878,232 60,878,232 563,754,356 563,754,356
Block
Small rural hospitals 5,510,416 5,510,416 60,707,772 60,707,772
Teaching, training & research 2,966,583 2,966,583 34,074,619 34,074,619
Non-admitted mental health 2,811,211 2,811,211 32,808,093 32,808,093
Other non-admitted services 15,800,673 15,800,673 214,845,540 214,845,540
Total Block (SMF) 27,088,884 27,088,884 342,436,024 342,436,024
Other
Public health funding 708,476 708,476 6,358,252 6,358,252
Overdeposit 0 0 0 0
Cross-border 825,708 825,708 825,708 825,708
Interest 0 0 5,228 5,228
Total Other (Pool) 1,534,184 1,534,184 7,189,187 7,189,187
Grand Total 89,501,300 89,501,300 913,379,568 913,379,568

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 – Tasmania, March 2019

This table shows NHR contributions (from state, territory and Commonwealth sources) made to each LHN in Tasmania 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)
($) ($) ($)
Tasmanian Health Organisation - North West 60,878,232 27,088,884 87,967,116
Total 60,878,232 27,088,884 87,967,116

See explanatory notes below table 4b.

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

This table shows YTD NHR contributions (from state, territory and Commonwealth sources) made to each LHN in Tasmania 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)
($) ($) ($)
Tasmanian Health Organisation - North West 563,754,356 342,436,024 906,190,380
Total 563,754,356 342,436,024 906,190,380

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 – Tasmania, 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 Tasmania.

Local hospital network (LHN) Estimated NWAU delivered in current month Estimated NWAU delivered YTD Estimated annual NWAU 2018-19
Tasmanian Health Organisation - North West 13,612 118,167 151,628
Total 13,612 118,167 151,628

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.