Tasmanian report, May 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 May 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, May 2019

The basis used to determine NHR payments to LHNs in Tasmania for May 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, May 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 May 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
26,258,872 26,258,872 26,258,872
Commonwealth
Block funding
6,117,234 6,117,234 6,117,234
Commonwealth
Other funding
691,111 691,111 691,111
Total C'wealth
funding
33,067,217 26,258,872 6,117,234 691,111 33,067,217
TAS
funding
37,248,403 37,248,403 0 0 37,248,403
Other state/territory funding 0 0 0 0
Total 70,315,620 63,507,275 6,117,234 691,111 0 70,315,620

See definitions and explanatory notes following table 1b.

Table 1b – State pool account transactions YTD – Tasmania, May 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 May 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
318,984,770 318,984,770 318,984,770
Commonwealth
Block funding
64,733,924 64,733,924 64,733,924
Commonwealth
Other funding
7,740,474 7,740,474 7,740,474
Total C'wealth
funding
391,459,169 318,984,770 64,733,924 7,740,474 391,459,169
TAS
funding
375,873,091 375,302,475 5,228 565,326 375,873,029
Other state/territory funding 260,382 0 260,382 260,382
Total 767,592,642 694,287,245 64,733,924 8,006,084 565,326 767,592,580

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, May 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 May 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 6,117,234 6,117,234
State/territory Block funding 20,454,771 20,454,771
Total 26,572,005 26,572,005 0 26,572,005

See explanatory notes following table 2b.

Table 2b – State managed fund transactions YTD – Tasmania, May 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 May 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 64,733,924 64,733,924
State/territory Block funding 359,594,272 359,594,272
Total 424,328,196 424,328,196 0 424,328,196

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, May 2019

This table shows NHR funding and payments by service category on both a monthly and year-to-date (YTD) basis for Tasmania for May 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 43,039,102 43,039,102 464,802,684 464,802,684
Admitted mental health 2,508,732 2,508,732 28,322,079 28,322,079
Sub-acute 2,828,862 2,828,862 30,947,606 30,947,606
Emergency department 7,551,409 7,551,409 88,009,829 88,009,829
Non-admitted 7,579,170 7,579,170 82,205,047 82,205,047
Total ABF (Pool) 63,507,275 63,507,275 694,287,245 694,287,245
Block
Small rural hospitals 5,404,823 5,404,823 74,830,557 74,830,557
Teaching, training & research 2,886,645 2,886,645 42,046,540 42,046,540
Non-admitted mental health 3,243,328 3,243,328 41,532,676 41,532,676
Other non-admitted services 15,037,209 15,037,209 265,918,423 265,918,423
Total Block (SMF) 26,572,005 26,572,005 424,328,196 424,328,196
Other
Public health funding 691,111 691,111 7,740,474 7,740,474
Overdeposit 0 0 0 0
Cross-border 0 0 825,708 825,708
Interest 0 0 5,290 5,228
Total Other (Pool) 691,111 691,111 8,571,472 8,571,410
Grand Total 90,770,391 90,770,391 1,127,186,913 1,127,186,851

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, May 2019

This table shows NHR contributions (from state, territory and Commonwealth sources) made to each LHN in Tasmania during May 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 63,507,275 26,572,005 90,079,280
Total 63,507,275 26,572,005 90,079,280

See explanatory notes below table 4b.

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

This table shows YTD NHR contributions (from state, territory and Commonwealth sources) made to each LHN in Tasmania as at May 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 694,287,245 424,328,196 1,118,615,441
Total 694,287,245 424,328,196 1,118,615,441

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, May 2019

This table shows estimated state or territory hospital activity for activity-based funding services expressed as NWAU for May 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 14,271 145,120 151,628
Total 14,271 145,120 151,628

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.