South Australian report, December 2017

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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 December 2017 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, December 2017

For the basis of the Commonwealth contribution to NHR funding, see Basis of Commonwealth NHR funding, 2017-18.

The basis used to determine NHR payments to LHNs in South Australia for December 2017 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, December 2017

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 December 2017.

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
91,992,044 91,992,044 91,992,044
Commonwealth
Block funding
14,583,846 14,583,846 14,583,846
Commonwealth
Other funding
2,257,987 2,257,987 2,257,987
Total C'wealth
funding
108,833,878 91,992,044 14,583,846 2,257,987 108,833,878
SA
funding
180,116,079 109,423,252 0 0 109,423,252
Other state/territory funding 0 0 0 0
Total 288,949,957 201,415,296 14,583,846 2,257,987 0 218,257,129

See definitions and explanatory notes following table 1b.

Table 1b – State pool account transactions YTD – South Australia, December 2017

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 December 2017.

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
551,952,265 551,952,265 551,952,265
Commonwealth
Block funding
87,503,078 87,503,078 87,503,078
Commonwealth
Other funding
13,547,923 13,547,923 13,547,923
Total C'wealth
funding
653,003,266 551,952,265 87,503,078 13,547,923 653,003,266
SA
funding
908,883,015 937,239,613 0 0 937,239,613
Other state/territory funding 0 0 0 0
Total 1,561,886,281 1,489,191,878 87,503,078 13,547,923 0 1,590,242,879

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.

For more information, see National Health Reform funding and payments.

State managed fund transactions

Table 2a – State managed fund transactions – South Australia, December 2017

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 December 2017.

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 14,583,846 14,583,846
State/territory Block funding 21,312,204 21,312,204
Total 35,896,050 35,896,050 0 35,896,050

See explanatory notes following table 2b.

Table 2b – State managed fund transactions YTD – South Australia, December 2017

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 December 2017.

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 87,503,078 87,503,078
State/territory Block funding 112,031,390 112,031,390
Total 199,534,469 199,534,469 0 199,534,469

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.

For more, see National Health Reform funding and payments.

NHR funding and payments by service category

Table 3 – NHR funding and payments by service category – South Australia, December 2017

This table shows NHR funding and payments by service category on both a monthly and year-to-date (YTD) basis for South Australia for December 2017. 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 170,281,560 126,120,261 917,207,889 937,840,423
Admitted mental health 20,811,074 15,188,302 120,853,086 123,974,322
Sub-acute 13,858,108 10,225,467 80,659,234 83,117,585
Emergency department 32,516,952 24,487,976 163,983,867 167,501,903
Non-admitted 34,524,351 25,393,289 177,248,188 176,757,644
Total ABF (Pool) 271,992,044 201,415,296 1,459,952,265 1,489,191,878
Block
Small rural hospitals 14,532,284 14,532,284 79,688,733 79,688,733
Teaching, training & research 7,097,846 7,097,846 39,881,936 39,881,936
Non-admitted mental health 9,670,467 9,670,467 54,666,625 54,666,625
Other non-admitted services 4,595,454 4,595,454 25,297,174 25,297,174
Total Block (SMF) 35,896,050 35,896,050 199,534,469 199,534,469
Other
Public health funding 2,257,987 2,257,987 13,547,923 13,547,923
Overdeposit 0 0 0 0
Cross-border 0 0 0 0
Interest 116,079 0 883,015 0
Total Other (Pool) 2,374,066 2,257,987 14,430,938 13,547,923
Grand Total 310,262,161 239,569,333 1,673,917,672 1,702,274,269

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.

For more information, see National Health Reform funding and payments.

NHR contributions by local hospital network

Table 4a – NHR contributions by local hospital network – South Australia, December 2017

This table shows NHR contributions (from state, territory and Commonwealth sources) made to each LHN in South Australia during December 2017.

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 45,266,155 5,548,191 50,814,346
Central Office Services 4,197,000 0 4,197,000
Country Health SA Local Health Network 27,500,000 20,800,000 48,300,000
Northern Adelaide Local Health Network 38,118,490 3,381,510 41,500,000
Southern Adelaide Local Health Network 64,922,032 5,377,968 70,300,000
Women's and Children's Health Network 21,411,619 788,381 22,200,000
Total 201,415,296 35,896,050 237,311,346

See explanatory notes below table 4b.

Table 4b – NHR contributions by local hospital network YTD – South Australia, December 2017

This table shows YTD NHR contributions (from state, territory and Commonwealth sources) made to each LHN in South Australia as at December 2017.

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 514,835,197 36,989,149 551,824,346
Central Office Services 25,182,000 0 25,182,000
Country Health SA Local Health Network 179,101,834 114,058,166 293,160,000
Northern Adelaide Local Health Network 237,570,939 20,189,061 257,760,000
Southern Adelaide Local Health Network 396,862,194 24,067,806 420,930,000
Women's and Children's Health Network 135,639,714 4,230,286 139,870,000
Total 1,489,191,878 199,534,469 1,688,726,346

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.

For more information, see National Health Reform funding and payments.

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, December 2017

This table shows estimated state or territory hospital activity for activity-based funding services expressed as NWAU for December 2017, 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 2017-18
Central Adelaide Local Health Network 8,971 102,028 203,373
Central Office Services 832 4,990 9,979
Country Health SA Local Health Network 5,450 35,494 68,218
Northern Adelaide Local Health Network 7,554 47,081 93,822
Southern Adelaide Local Health Network 12,866 78,649 153,487
Women's and Children's Health Network 4,243 26,881 53,485
Total 39,916 295,123 582,364

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.