Western Australian 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 Western Australia 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 WA Department of Health to view the service agreement for that LHN.

Basis for National Health Reform payments – Western Australia, March 2019

The basis used to determine NHR payments to LHNs in Western Australia for March 2019 is as follows:

Service agreements between the Department of Health (the Department) and Health Service Providers (HSPs) are based on the Department’s funding and purchasing policies and resource allocation models.

The Western Australia Activity- Based Funding (WA ABF) model determines the price at which the Department purchases services from HSPs and the type and volume of services that are purchased. Metropolitan public hospitals and Regional and District rural hospitals are funded through the WA ABF model. The WA ABF model is based on the national ABF model however, it includes a range of modifications reflecting WA funding principles and purchasing mechanisms.

Small rural hospitals are funded through block funding arrangements which, although based on the National Efficient Cost Determination contain some funding modifications.

The vast majority of non-hospital services are block-funded. Block funding is based on budget to budget build from the previous year using WA State Government funding parameters consistent with the WA State budget.

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 – Western Australia, March 2019

This table shows funding paid into the Western Australian state pool account by the Commonwealth, Western Australia or other states/territories, and payments out of the state pool account to LHNs, the state managed fund, the WA 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
157,434,542 157,434,542 157,434,542
Commonwealth
Block funding
23,821,772 23,821,772 23,821,772
Commonwealth
Other funding
3,523,620 3,523,620 3,523,620
Total C'wealth
funding
184,779,935 157,434,542 23,821,772 3,523,620 184,779,935
WA
funding
299,581,918 299,321,528 0 260,382 299,581,910
Other state/territory funding 565,326 0 565,326 565,326
Total 484,927,178 456,756,071 23,821,772 4,088,946 260,382 484,927,171

See definitions and explanatory notes following table 1b.

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

Following on from table 1a, this table shows year-to-date (YTD) funding paid into the Western Australian state pool account by the Commonwealth, Western Australia or other states/territories, and payments out of the state pool account to LHNs, the state managed fund, the WA 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
1,430,462,188 1,430,462,188 1,430,462,188
Commonwealth
Block funding
224,575,541 224,575,541 224,575,541
Commonwealth
Other funding
30,438,158 30,438,158 30,438,158
Total C'wealth
funding
1,685,475,887 1,430,462,188 224,575,541 30,438,158 1,685,475,887
WA
funding
1,944,850,017 1,944,589,563 0 260,382 1,944,849,945
Other state/territory funding 565,326 0 565,326 565,326
Total 3,630,891,230 3,375,051,751 224,575,541 31,003,484 260,382 3,630,891,158

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.

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

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

This table shows funding paid into the Western Australia state managed fund by the Commonwealth and Western Australia, 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 23,821,772 23,821,772
State/territory Block funding 15,555,647 15,555,647
Total 39,377,418 38,713,362 664,056 39,377,418

See explanatory notes following table 2b.

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

Following on from table 2a, this table shows year-to-date (YTD) funding paid into the Western Australian state managed fund by the Commonwealth and Western Australia, 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 224,575,541 224,575,541
State/territory Block funding 188,620,032 188,620,032
Total 413,195,572 407,219,068 5,976,505 413,195,572

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 Western 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 – Western Australia, March 2019

This table shows NHR funding and payments by service category on both a monthly and year-to-date (YTD) basis for Western Australia 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 286,083,889 286,083,889 2,087,949,859 2,087,949,859
Admitted mental health 22,569,197 22,569,197 203,122,776 203,122,776
Sub-acute 25,952,104 25,952,104 196,912,866 196,912,866
Emergency department 61,370,609 61,370,609 445,363,206 445,363,206
Non-admitted 60,780,271 60,780,271 441,703,045 441,703,045
Total ABF (Pool) 456,756,071 456,756,071 3,375,051,751 3,375,051,751
Block
Small rural hospitals 8,555,773 8,014,284 108,715,079 108,715,079
Teaching, training & research 9,635,867 9,635,867 103,628,893 103,628,893
Non-admitted mental health 20,723,666 21,265,155 186,512,993 186,512,993
Other non-admitted services 462,113 462,113 14,338,607 14,338,607
Total Block (SMF) 39,377,418 39,377,418 413,195,572 413,195,572
Other
Public health funding 3,523,620 3,523,620 30,438,158 30,438,158
Overdeposit 0 0 0 0
Cross-border 825,708 825,708 825,708 825,708
Interest 7 0 72 0
Total Other (Pool) 4,349,335 4,349,328 31,263,938 31,263,866
Grand Total 500,482,825 500,482,817 3,819,511,261 3,819,511,190

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 – Western Australia, March 2019

This table shows NHR contributions (from state, territory and Commonwealth sources) made to each LHN in Western Australia 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)
($) ($) ($)
Child and Adolescent Health Service 34,706,860 1,262,006 35,968,866
East Metropolitan Health Service 82,701,126 7,681,173 90,382,299
North Metropolitan Health Service 122,281,210 10,210,261 132,491,471
Notional LHN - Royal Street - WA 3,159,283 0 3,159,283
South Metropolitan Health Service 108,452,953 6,077,386 114,530,338
WA Country Health Service 105,454,639 13,482,537 118,937,176
Total 456,756,071 38,713,362 495,469,433

See explanatory notes below table 4b.

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

This table shows YTD NHR contributions (from state, territory and Commonwealth sources) made to each LHN in Western Australia 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)
($) ($) ($)
Child and Adolescent Health Service 254,000,462 19,530,310 273,530,772
East Metropolitan Health Service 674,778,884 69,130,555 743,909,439
North Metropolitan Health Service 959,263,730 106,892,349 1,066,156,080
Notional LHN - Royal Street - WA 33,663,030 0 33,663,030
South Metropolitan Health Service 784,919,756 57,053,810 841,973,566
WA Country Health Service 668,425,889 154,612,044 823,037,933
Total 3,375,051,751 407,219,068 3,782,270,819

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 – Western Australia, 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 Western Australia.

Local hospital network (LHN) Estimated NWAU delivered in current month Estimated NWAU delivered YTD Estimated annual NWAU 2018-19
Child and Adolescent Health Service 4,853 41,169 54,773
East Metropolitan Health Service 17,334 147,479 196,235
North Metropolitan Health Service 21,639 189,753 254,726
Notional LHN - Royal Street - WA 1,422 11,948 15,909
South Metropolitan Health Service 20,489 176,228 230,989
WA Country Health Service 11,667 100,028 132,908
Total 77,403 666,605 885,540

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.