To meet the reporting requirements of Section 240 of the National Health Reform Act 2011, the Administrator is to include the basis of each State and Territory's National Health Reform (NHR) funding and payments.
The Queensland efficient price is based on the funding pool within the Activity Based Funding (ABF) scope of services within hospital and health services, which reflects the indexation funded and productivity required by the State. Further State specific adjustments for quality and safety, education and training and models of care variation are calculated as required. Queensland utilises the National Weighted Activity Unit (NWAU20) as the underlying weights in the Queensland model for the calculation of service outputs.
The stand-alone hospitals providing specialist Mental Health Services (admitted and non-admitted), Child and Adolescent Mental Health Services, Non-admitted Home Ventilation utilises the National Efficient Cost (NEC20) Block funded model. The small regional and remote hospitals are benchmarked against the NEC20 Block funded model, and receive funding based on system priorities.
Queensland Clinical Teaching, Training, and Research model is based on a state localised model and provided to the ABF LHNs.
NHR payments in Queensland are based upon the activity outlined in the Budget Statements as agreed between the Minister for Health, Queensland Treasury and the Director-General, Queensland Health.
The funding and purchased activity are outlined in each of the Hospital and Health Service (HHS) Service Agreements and outlines:
- The schedule of services to be delivered by or on behalf of the HHS and the funding to be provided in relation to the provision of those services.
- The block funding to be provided to:
- Small rural hospitals, standalone hospitals providing specialist mental health services and eligible community mental health services
- Major hospitals for:
- Non-admitted Home Ventilation
- Highly Specialised Therapies
- Clinical Teaching, Training and Research
- Operational and block grants to the HHS covering services provided and activities undertaken that are not within scope for ABF, for example, community dental services, primary care, home and community care.
- Supplementation Grants at the ABF stream level in recognition that the HHS is to deliver services or models of care that are new to the case mix classification and these costs are greater than average costs in the NEP.
- Standards of patient care and service delivery.
- Performance standards, performance targets and performance measures for the HHS.
- Requirements for the HHS to report on its performance, as required or otherwise.
- A performance management process that is to be in continuous operation in respect of the HHS.
The ABF funded facilities’ service profiles are developed in negotiation with the HHS as follows:
- Acute admitted and Sub-acute and Non-acute service activity volumes are modelled based on historical activity data, agreed growth rates and adjusted for known service capacity and profile changes.
- Emergency Department and Outpatient service volumes are modelled based on agreed growth rates and other known factors.
- Clinical Teaching and Training is based on methodologies applied to salaried employees in clinical training positions, under-graduate and post-graduate student scholarship and clinical placements.
- Home Ventilation services are based on historical expenditure profiles and adjusted for known patient volume changes.
- Small regional and remote hospitals are modelled based on the expenditure reported and the small hospital NEC results.
- Stand-alone hospitals providing specialist Mental Health services (admitted and non-admitted) are modelled based on historical expenditure profiles and adjusted for known changes in service delivery and new system investment through the Mental Health Connecting Care to Recovery.
- Non-NHRA services that are activity driven, e.g. in the case of a Department of Veteran Affairs (DVA) hospital admissions, are included in the activity target calculations, noting that these are funded by that program.
- Other non-NHRA and non-hospital services are block-funded and based on historical funding and other known growth factors.
Further information regarding the Basis for National Health Reform payments in both 2020-21 and previous financial years is included at www.publichospitalfunding.gov.au