National Health Reform
Public hospital funding
Western Australian report
March 2013
Issued by the Administrator of the National Health Funding Pool
under section 240 of the National Health Reform Act 2011
Available from the Public Hospital Funding website
Western Australian report, March 2013
Table of Contents:
- Participation in the National Health Funding Pool
- Local hospital networks and National Health Reform
- Basis for National Health Reform payments
- Reference information
- Transactions on the state pool account
- Transactions on the state managed fund
- NHR funding and payments by service category
- NHR payment distribution by LHN
- Estimated monthly, YTD and annual NWAU by LHN
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 2013 as part of the National Health Reform Agreement.
Participation in the National Health Funding Pool
In signing the National Health Reform Agreement (the Agreement), it was the intention of all states and territories that they would have the necessary legislation in place to enable them to participate in the National Health Funding Pool from 1 July 2012.
Western Australia has participated in the National Health Funding Pool since 1 July 2012.
Local hospital networks and National Health Reform
Under the Agreement, local hospital networks 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: Local hospital networks 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 local hospital network, contact the Western Australian Department of Health to view the service agreement for that local hospital network.
Basis for National Health Reform payments
For the basis of the Commonwealth contribution to NHR funding, see Basis of Commonwealth funding 2012-13.
The basis used to determine NHR payments to local hospital networks (LHNs) in Western Australia for March 2013 was advised by Western Australia to be as follows:
The 2012-13 annual funding allocations for Western Australia have been developed using the Western Australian Activity Based Funding (ABF) program methodology. Activity profiles have been developed consistent with the WA Health clinical services framework. The funding allocations include activity based services, block funded services and specified programs. The national activity based funding classifications and associated price weights including all of the loadings (specialised paediatric, rural/remote, indigenous, intensive care unit (ICU) and private patient) have been used to define activity based funding profiles. State specific loadings have been applied to adjust for peer relativities in the metropolitan area and for rural and remote sites. Block funding is based on budget to budget build from the previous year using State Government funding parameters consistent with the State budget.
Monthly allocations to local hospital networks will vary for a variety of reasons, for example, allowance for annual insurance premiums, or variation in number of staff pay days in a month.
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 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.
Transactions on the state pool account
This table shows funding paid into the Western Australian state pool account by the Commonwealth and Western Australia, and payments out of the state pool account to local hospital networks, the state managed fund, and the state health department for March 2013.
Table 1a – State pool account transactions – Western Australia, March 2013
| 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 |
Total paid out | ||
| ($) | ($) | ($) | ($) | ($) | |
| Commonwealth ABF funding |
84,567,916 | 84,567,916 | 84,567,916 | ||
| Commonwealth Block funding |
28,184,161 | 28,184,161 | 28,184,161 | ||
| Commonwealth Other funding |
2,704,986 | 2,704,986 | 2,704,986 | ||
| Total Commonwealth funding |
115,457,062 | 84,567,916 | 28,184,161 | 2,704,986 | 115,457,062 |
| Total state/territory funding |
214,225,338 | 214,225,338 | 0 | 214,225,338 | |
| Grand Total | 329,682,401 | 298,793,254 | 28,184,161 | 2,704,986 | 329,682,401 |
See definitions and explanatory notes following table 1b.
Following on from table 1a, this table shows the year-to-date (YTD) funding paid into the Western Australian state pool account by the Commonwealth and Western Australia, and payments out of the state pool account to local hospital networks, the state managed fund, and the state health department as at March 2013.
Table 1b – State pool account transactions YTD – Western Australia, March 2013
| NHR funding by source | Paid into state pool account YTD | Paid out of state pool account YTD | |||
|---|---|---|---|---|---|
| To local hospital networks | To state managed fund |
To state health department | Total paid out YTD |
||
| ($) | ($) | ($) | ($) | ($) | |
| Commonwealth ABF funding |
767,585,594 | 767,585,594 | 767,585,594 | ||
| Commonwealth Block funding |
255,799,771 | 255,799,771 | 255,799,771 | ||
| Commonwealth Other funding |
24,445,889 | 24,445,889 | 24,445,889 | ||
| Total Commonwealth funding |
1,047,831,254 | 767,585,594 | 255,799,771 | 24,445,889 | 1,047,831,254 |
| Total state/territory funding |
2,044,910,652 | 2,044,910,652 | 0 | 2,044,910,652 | |
| Grand Total | 3,092,741,906 | 2,812,496,246 | 255,799,771 | 24,445,889 | 3,092,741,906 |
Commonwealth ABF funding represents Acute admitted public, Acute admitted private, Non-admitted, and Emergency department service categories, which are funded by the Commonwealth through the state pool account and subsequently paid to local hospital networks.
Commonwealth Block funding represents Mental health, Small rural and metropolitan hospitals, Sub-acute, Teaching, training and research, and Other 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.
State/territory funding represents funding contributions paid in by Western Australia into its own state pool account, and subsequently paid to local hospital networks within the state or territory and/or to state or territory health departments.
Note: The grey shaded areas in these tables reflect that these amounts are not applicable for a particular 'paid out' column. For example, Commonwealth block funding is only paid to state managed funds and is not applicable for local hospital networks or state or territory health departments.
NHR funding and payments shown in these tables include GST where applicable.
For more information on NHR funding and payments, see National Health Reform funding and payments.
Transactions on the state managed fund
This table shows funding paid into the Western Australian state managed fund by the Commonwealth and Western Australia and payments out of the state managed fund for March 2013.
Table 2a – State managed fund transactions – Western Australia, March 2013
| 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 | 28,184,161 | 28,184,161 | ||
| State/territory Block funding | 40,191,000 | 40,191,000 | ||
| Total | 68,375,161 | 68,375,161 | 0 | 68,375,161 |
See explanatory notes following table 2b.
Following on from table 2a, this table shows the year-to-date (YTD) funding paid into the Western Australian state managed fund by the Commonwealth and Western Australia and payments out of the state managed fund as at March 2013.
Table 2b – State managed fund transactions YTD – Western Australia, March 2013
| NHR funding by source | Paid into state managed fund YTD | Paid out of state managed fund YTD | ||
|---|---|---|---|---|
| To local hospital networks | To Other | Total paid out YTD |
||
| ($) | ($) | ($) | ($) | |
| Commonwealth Block funding | 255,799,771 | 255,799,771 | ||
| State/territory Block funding | 570,569,000 | 570,569,000 | ||
| Total | 826,368,771 | 826,368,771 | 0 | 826,368,771 |
Block funding represents Mental health, Small rural and metropolitan hospitals, Sub-acute, Teaching, training and research, and Other 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 local hospital networks 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 local hospital networks 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 information on NHR funding and payments, see National Health Reform funding and payments.
NHR funding and payments by service category
This table shows the NHR funding and payments by service category on both a monthly and year-to-date (YTD) basis for Western Australia for March 2013.
NHR funding and payments are separated into an activity based funding (ABF) component, block component, and other components.
Table 3 – NHR funding and payments by service category – Western Australia, March 2013
| Service category | NHR funding | NHR payments | NHR funding YTD |
NHR payments YTD |
|---|---|---|---|---|
| ($) | ($) | ($) | ($) | |
| ABF | ||||
| Acute admitted - public | 199,059,421 | 199,059,421 | 1,871,174,314 | 1,871,174,314 |
| Acute admitted - private | 21,211,901 | 21,211,901 | 198,820,388 | 198,820,388 |
| Non-admitted | 39,210,192 | 39,210,192 | 367,700,638 | 367,700,638 |
| Emergency department | 39,311,740 | 39,311,740 | 374,800,906 | 374,800,906 |
| Total ABF (Pool) | 298,793,254 | 298,793,254 | 2,812,496,246 | 2,812,496,246 |
| Block | ||||
| Mental health | 22,337,473 | 22,337,473 | 207,611,194 | 207,557,861 |
| Small rural & metro hospitals | 11,953,960 | 11,946,435 | 122,848,347 | 122,770,729 |
| Sub-acute | 6,200,240 | 6,207,450 | 77,235,602 | 77,244,918 |
| Teaching, training & research | 7,334,105 | 7,334,105 | 89,185,808 | 89,312,015 |
| Other | 20,549,384 | 20,549,698 | 329,487,820 | 329,483,248 |
| Total Block (SMF) | 68,375,161 | 68,375,161 | 826,368,771 | 826,368,771 |
| Other | ||||
| Public health funding | 2,704,986 | 2,704,986 | 24,445,889 | 24,445,889 |
| Overdeposit | 0 | 0 | 0 | 0 |
| Cross border | 0 | 0 | 0 | 0 |
| Interest | 0 | 0 | 0 | 0 |
| Total Other (Pool) | 2,704,986 | 2,704,986 | 24,445,889 | 24,445,889 |
| Grand Total | 369,873,401 | 369,873,401 | 3,663,310,906 | 3,663,310,906 |
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, which are 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 local hospital networks - 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 local hospital networks are already being funded for the cost of treating cross-border patients - shown in the Cross border payment row under Other in the above table.
Cross border funding arrangements between states and territories are yet to be put in place for state and territory contributions.
NHR funding and payments shown in these tables include GST where applicable.
For more information on NHR funding and payments, see National Health Reform funding and payments.
NHR payment distribution by LHN
This table shows NHR payments (from state, territory and Commonwealth sources) made to each local hospital network (LHN) in Western Australia during March 2013.
NHR payments are separated into an activity based funding (ABF) component and a block component.
Table 4 – NHR payment distribution by LHN – Western Australia, March 2013
| Local hospital network (LHN) | ABF component (ex GST) |
Block component (ex GST) |
Total NHR payments (ex GST) |
|---|---|---|---|
| ($) | ($) | ($) | |
| Child and Adolescent Health Service | 21,202,653 | 3,316,438 | 24,519,090 |
| North Metropolitan Health Service | 101,434,946 | 24,472,132 | 125,907,077 |
| South Metropolitan Health Service | 124,286,639 | 11,081,207 | 135,367,846 |
| WA Country Health Service | 51,869,017 | 29,505,384 | 81,374,401 |
| Total | 298,793,254 | 68,375,161 | 367,168,415 |
A local hospital network (LHN) is an organisation that provides public hospital services in accordance with the National Health Reform Agreement. A local hospital network 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 a local hospital network.
NHR payments in this table are GST exclusive to enable comparability of NHR payments in each local hospital network report.
Note: This table excludes GST and payments to other provider organisations (non-local hospital networks).
Note: The majority of government funding to local hospital networks 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 on NHR funding and payments, see National Health Reform funding and payments.
Estimated monthly, YTD and annual NWAU by LHN
This table shows estimated state or territory hospital activity for activity based funding services expressed as National Weighted Activity Units (NWAU) for March 2013, the associated cumulative year-to-date (YTD) and total annual estimated NWAU for each local hospital network in Western Australia.
NHR funding amounts and service volumes are provided by states and territories as service estimates at the start of each financial year, and may continue to be refined during the course of the year. These estimates form the basis of monthly reporting of service volumes until actual service numbers become available.
The estimated annual NWAU for each local hospital network (LHN) was provided to the Administrator as a basis for determining the Commonwealth NHR activity based funding. Current month NWAU estimates accumulate through the year-to-date NWAU to equal the annual NWAU at the end of the financial year.
Table 5 – Estimated monthly, YTD and annual NWAU by LHN – Western Australia, March 2013
| Local hospital network (LHN) | Estimated NWAU delivered in current month | Estimated NWAU delivered YTD | Estimated annual NWAU 2012-13 |
|---|---|---|---|
| Child and Adolescent Health Service | 4,051 | 35,983 | 48,262 |
| North Metropolitan Health Service | 19,654 | 163,941 | 216,653 |
| South Metropolitan Health Service | 24,252 | 206,269 | 272,581 |
| WA Country Health Service | 7,304 | 61,317 | 81,471 |
| Total | 55,261 | 467,510 | 618,967 |
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 NHR funding and payments, see National Health Reform funding and payments.
For more information on the NWAU calculation, see Calculation of NWAU.