National Health Reform Public Hospital Funding. Queensland Report January 2015

Transcription

1 National Health Reform Public Hospital Funding Queensland Report January 2015 Issued by the Administrator of the National Health Funding Pool under section 240 of the National Health Reform Act 2011

2 This report is available from the National Health Reform Public Hospital Funding website at

3 National Health Reform public hospital Queensland report January 2015 This report is issued by the Administrator of the National Health Funding Pool under section 240 of the National Health Reform Act This report is prepared on a cash basis. It shows monthly and year-to-date () National Health Reform (NHR) and payments for Queensland for January 2015 as part of the National Health Reform Agreement. In this report This report includes the following tables: State pool account transactions Table 1a State pool account transactions Queensland, January 2015 Table 1b State pool account transactions Queensland, January 2015 State managed fund transactions Table 2a State managed fund transactions Queensland, January 2015 Table 2b State managed fund transactions Queensland, January 2015 NHR and payments by service category Table 3 NHR and payments by service category Queensland, January 2015 NHR contributions by local hospital network Table 4a NHR contributions by local hospital network Queensland, January 2015 Table 4b NHR contributions by local hospital network Queensland, January 2015 Estimated monthly, and annual activity Table 5 Estimated monthly, and annual NWAU by local hospital network Queensland, January 2015 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 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. National Health Reform public hospital Queensland report, January 2015 Page 3

4 Note: LHNs also receive 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 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, January 2015 For the basis of the Commonwealth contribution to NHR, see Basis of Commonwealth NHR, The basis used to determine NHR payments to LHNs in Queensland for January 2015 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 and purchasing models. In broad terms, the 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 model: 34 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. 89 public hospitals, predominantly small regional and rural hospitals, are funded through block arrangements which take account of hospital size and location. These are based on the National Efficient Cost Determination with some minor modifications. Most non-hospital services (e.g. preventive health, primary and community health) are funded based on historical 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 of services that the Department agrees to purchase from each HHS through the service agreement. The model is informed by Estimated Future Activity for each HHS and other key priorities for investment. Interest received in the pool account from the Reserve Bank of Australia is returned to the Queensland Government s Consolidated Fund and is not used for NHR. Reference information The financial information outlined in the following report is categorised as: NHR when the Commonwealth or state or territory government pays NHR into a state pool account or state managed fund. NHR payments when NHR 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. National Health Reform public hospital Queensland report, January 2015 Page 4

5 State pool account transactions Table 1a State pool account transactions Queensland, January 2015 This table shows 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, and the Queensland Department of Health or the state pool accounts of other states/territories for January NHR by source Commonwealth ABF Commonwealth Block Commonwealth Other Total C'wealth Paid into state pool account To Local hospital networks To State Managed Fund Paid out of state pool account To state health department To state pool (other State) Total paid out ($) ($) ($) ($) ($) ($) 214,961, ,961, ,961,666 32,798,497 32,798,497 32,798,497 5,683,550 5,683,550 5,683, ,443, ,961,666 32,798,497 5,683, ,443,713 QLD 418,661, ,620, ,620,793 Other state/territory Total 672,105, ,582,458 32,798,497 5,683, ,064,505 See definitions and explanatory notes following table 1b. National Health Reform public hospital Queensland report, January 2015 Page 5

6 Table 1b State pool account transactions Queensland, January 2015 Following on from table 1a, this table shows year-to-date () 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 January NHR by source Commonwealth ABF Commonwealth Block Commonwealth Other Total C'wealth Paid into state pool account To Local hospital networks Paid out of state pool account To State Managed Fund To state health department To state pool (other State) Total paid out ($) ($) ($) ($) ($) ($) 1,499,560,149 1,499,560,149 1,499,560, ,943, ,943, ,943,697 39,963,501 39,963,501 39,963,501 1,769,467,346 1,499,560, ,943,697 39,963,501 1,769,467,346 QLD 2,987,650,171 2,987,326, ,987,326,074 Other state/territory Total 4,757,117,517 4,486,886, ,943,697 39,963, ,756,793,420 Commonwealth ABF 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 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 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 represents 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 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 is only paid to state managed funds and not to local hospital networks or state or territory health departments. NHR and payments shown in these tables include GST where applicable. For more information, see National Health Reform and payments. National Health Reform public hospital Queensland report, January 2015 Page 6

7 State managed fund transactions Table 2a State managed fund transactions Queensland, January 2015 This table shows 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 January NHR by source Paid into state managed fund To local hospital networks Paid out of state managed fund To Other Total paid out ($) ($) ($) ($) Commonwealth Block 32,798,497 32,798,497 State/territory Block 71,645,828 71,645,828 Total 104,444, ,444, ,444,326 See explanatory notes below table 2b. Table 2b State managed fund transactions Queensland, January 2015 Following on from table 2a, this table shows year-to-date () 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 as at January NHR by source Paid into state managed fund To local hospital networks Paid out of state managed fund To Other Total paid out ($) ($) ($) ($) Commonwealth Block 229,943, ,943,697 State/territory Block 536,727, ,727,041 Total 766,670, ,670, ,670,738 Block represents Non-admitted mental health, Small rural hospitals, Teaching, training & research, and Other non-admitted categories. Commonwealth Block represents Commonwealth block 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 represents Queensland block 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 (state, territory or Commonwealth contribution). NHR and payments shown in these tables include GST where applicable. For more information, see National Health Reform and payments. National Health Reform public hospital Queensland report, January 2015 Page 7

8 NHR and payments by service category Table 3 NHR and payments by service category Queensland, January 2015 This table shows NHR and payments by service category on both a monthly and year-to-date () basis for Queensland for January NHR and payments are separated into the following service categories activity-based (ABF), block, and other. ABF Service category NHR NHR NHR NHR payments payments ($) ($) ($) ($) Acute admitted 399,073, ,073,684 2,846,834,032 2,846,834,032 Admitted mental health 32,096,787 32,096, ,660, ,660,003 Sub-acute 33,784,455 33,784, ,260, ,260,771 Emergency department 92,858,678 92,858, ,937, ,937,935 Non-admitted 75,768,853 75,768, ,193, ,193,481 Total ABF (Pool) 633,582, ,582,458 4,486,886,222 4,486,886,222 Block Small rural hospitals 56,254,363 56,506, ,851, ,657,972 Teaching, training & research 21,987,099 21,987, ,065, ,040,488 Non-admitted mental health 25,682,339 25,503, ,151, ,881,918 Other non-admitted services 520, ,401 4,603,095 4,090,360 Total Block (SMF) 104,444, ,444, ,670, ,670,738 Other Public health 5,683,550 5,683,550 39,963,501 39,963,501 Overdeposit Cross border Interest 40, ,097 0 Total Other (Pool) 5,724,058 5,683,550 40,287,598 39,963,501 Grand Total 743,750, ,710,334 5,293,844,558 5,293,520,461 Total ABF (Pool) is an aggregate of both Commonwealth and state or territory NHR and payments for activity-based (ABF) which is transacted through the state pool account. Total Block (SMF) is an aggregate of both Commonwealth and state or territory NHR and payments for block which is transacted through the state managed fund (SMF). Total Other (Pool) represents other and payments transacted through the state pool account, including public health, overdeposits, cross-border 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 and payments shown in these tables include GST where applicable. For more information, see National Health Reform and payments. National Health Reform public hospital Queensland report, January 2015 Page 8

9 NHR contributions by local hospital network Table 4a NHR contributions by local hospital network Queensland, January 2015 This table shows NHR contributions (from state, territory and Commonwealth sources) made to each LHN in Queensland during January NHR contributions to LHNs are separated into an activity-based (ABF) component and a block component. Local hospital network ABF component Block component Total NHR payments ($) ($) ($) Cairns and Hinterland Hospital and Health Service 38,181,369 7,059,755 45,241,123 Central Queensland Hospital and Health Service 20,535,725 6,877,482 27,413,207 Central West Hospital and Health Service 0 2,346,557 2,346,557 Children's Health Queensland Hospital and Health Service 24,169, ,477 24,958,402 Darling Downs Hospital and Health Service 25,356,225 14,230,842 39,587,066 Gold Coast Hospital and Health Service 76,060,582 4,663,709 80,724,291 Mackay Hospital and Health Service 17,946,211 3,687,627 21,633,838 Mater Misericordiae Health Service Brisbane 24,553,011 1,536,305 26,089,316 Metro North Hospital and Health Service 135,141,985 10,716, ,858,928 Metro South Hospital and Health Service 126,089,527 13,846, ,935,806 North West Hospital and Health Service 5,872,100 2,240,869 8,112,969 South West Hospital and Health Service 0 5,229,864 5,229,864 Sunshine Coast Hospital and Health Service 45,331,999 3,658,109 48,990,108 Torres and Cape Hospital and Health Service 0 4,388,108 4,388,108 Townsville Hospital and Health Service 38,257,975 9,370,377 47,628,352 West Moreton Hospital and Health Service 22,676,683 9,381,569 32,058,252 Wide Bay Hospital and Health Service 30,953,840 4,267,826 35,221,666 Total 631,127, ,290, ,417,852 See explanatory notes below table 4b. Table 4b NHR contributions by local hospital network Queensland, January 2015 This table shows NHR contributions (from state, territory and Commonwealth sources) made to each LHN in Queensland as at January NHR contributions to LHNs are separated into an activity-based (ABF) component and a block component. Local hospital network ABF component Block component Total NHR payments ($) ($) ($) Cairns and Hinterland Hospital and Health Service 274,340,633 51,759, ,100,530 Central Queensland Hospital and Health Service 149,072,555 50,353, ,426,146 Central West Hospital and Health Service 0 17,148,109 17,148,109 National Health Reform public hospital Queensland report, January 2015 Page 9

10 Local hospital network ABF component Block component Total NHR payments Children's Health Queensland Hospital and Health Service 171,897,456 10,337, ,235,339 Darling Downs Hospital and Health Service 172,892, ,087, ,979,764 Gold Coast Hospital and Health Service 472,960,102 34,388, ,348,910 Mackay Hospital and Health Service 124,910,730 27,026, ,937,503 Mater Misericordiae Health Service Brisbane 276,767,552 7,928, ,696,279 Metro North Hospital and Health Service 947,476,790 78,933,883 1,026,410,673 Metro South Hospital and Health Service 854,322, ,721, ,043,589 North West Hospital and Health Service 38,955,360 16,393,874 55,349,234 South West Hospital and Health Service 0 38,218,667 38,218,667 Sunshine Coast Hospital and Health Service 315,558,931 26,883, ,442,192 Torres and Cape Hospital and Health Service 0 32,067,333 32,067,333 Townsville Hospital and Health Service 300,606,480 68,683, ,289,599 West Moreton Hospital and Health Service 156,265,308 68,651, ,916,486 Wide Bay Hospital and Health Service 203,182,574 31,294, ,476,979 Total 4,459,209, ,877,865 5,225,087,332 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 to LHNs is not subject to GST. However in some cases hospital 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. For more information, see National Health Reform and payments. National Health Reform public hospital Queensland report, January 2015 Page 10

11 Estimated monthly, 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. Current month NWAU estimates accumulate through the year-to-date () 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, and annual NWAU by local hospital network Queensland, January 2015 This table shows estimated state or territory hospital activity for activity-based services expressed as NWAU for January 2015, the associated cumulative year-to-date (), and total estimated annual NWAU for each LHN in Queensland. Local hospital network Estimated NWAU delivered in current month Estimated NWAU delivered Estimated annual NWAU Cairns and Hinterland Hospital and Health Service 7,433 51,548 89,198 Central Queensland Hospital and Health Service 3,903 27,117 46,840 Children's Health Queensland Hospital and Health Service 3,749 26,645 44,994 Darling Downs Hospital and Health Service 4,737 33,735 56,843 Gold Coast Hospital and Health Service 12,225 85, ,698 Mackay Hospital and Health Service 3,235 22,732 38,818 Mater Misericordiae Health Service Brisbane 5,910 41,547 70,924 Metro North Hospital and Health Service 24, , ,779 Metro South Hospital and Health Service 21, , ,034 North West Hospital and Health Service 966 6,759 11,586 Sunshine Coast Hospital and Health Service 8,258 58,506 99,092 Townsville Hospital and Health Service 7,651 52,192 91,808 West Moreton Hospital and Health Service 4,308 30,409 51,693 Wide Bay Hospital and Health Service 5,292 37,841 63,498 Total 113, ,341 1,361,805 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. For more information on the NWAU calculation, see Calculation of NWAU. National Health Reform public hospital Queensland report, January 2015 Page 11