Funding and payments
Section 240 of the NHR Act(Opens in a new tab/window) requires the Administrator to provide monthly reports to the Commonwealth and each State and Territory. These reports are made publicly available via publichospitalfunding.gov.au to improve the transparency of public hospital funding.
Monthly reports provide details of funding and payments into and out of the Pool and State Managed Funds. This information is provided at a national, State and Territory and LHN level, and details both the Commonwealth and State and Territory contributions.
The NHFB produces approximately 160 reports each month on behalf of the Administrator, comprising of:
- a national report
- a report for each State and Territory
- a report for each LHN.
These reports are prepared on a cash basis and align to the reporting of funding and payments provided in this Annual Report. Full year 2023-24 funding and payment information was published to the website on 16 July 2024, within three weeks after the end of the financial year.
Compliance
The Administrator’s rolling Three Year Data Plan sets out the minimum level of data that States, Territories and the Commonwealth must provide to the Administrator, and the timeframes it must be provided within.
Each quarter, a compliance report is published that details whether States, Territories and the Commonwealth have met their obligations under the Data Plan.
Through engagement with States and Territories, Compliance with the Administrator’s Data Plan has improved over time, including the timeliness of data submissions. However there are some areas of concern that require more work, such as transparency of out-of-scope activity and State Prices.
Data submissions
2023-24 Annual NHR Data Submissions.
As reported in the Administrator's September 2024 Compliance Report, with respect to Submission A, seven out of eight States provided their data on time with NSW providing a data submission in late October. This is similar to the third quarter of 2023- 24, where there was a delay due to a late mental health data submission by NSW. Six of the eight States provided their Statement of Assurance on time, with NSW and the Northern Territory yet to submit. Queensland and South Australia provided Private Patient Revenue by 30 September 2024. Two of the four States that deliver Highly Specialised Therapies provided data submissions on time. All states provided Sentinel Events data, with the Australian Capital Territory reporting no Sentinel Events for 2023-24. Submission B was submitted by six out of eight states by 30 September 2024, with Queensland submitting on 1 October 2024, and NSW submitting on 31 October 2024.
The delays of the 2023-24 Annual data submissions have affected the overall timeliness in this reporting period.
Service agreements
Service Agreements between the States and LHNs support transparency of public hospital funding and services and are provided to the Administrator (once agreed). Service Agreements are to include, at a minimum (E7):
a. the number and broad mix of services to be provided by the LHN, to inform the community of the expected outputs from the LHN and allow the Administrator to calculate the Commonwealth’s funding contribution
b. the quality and service standards that apply to services delivered by the LHN, including the Performance and Accountability Framework and the level of funding to be provided to the LHN under the Service Agreement, through ABF and Block funding
c. the teaching, training and research functions to be undertaken at the LHN level.
In addition, the funding paid on an activity basis to LHNs will be based on the price set by that State as reported in Service Agreements, the State Price (A92).
The Administrator and NHFB have been working with States and Territories to highlight inconsistencies in Service Agreements and identify where improvements can be made including on:
- accuracy of State Prices
- identification of in-scope and out-of-scope activity
- timely provision of Service Agreements to the Administrator.
As reported in the Administrator's September 2024 Quarterly Compliance Report, three out of eight States and Territories submitted all 2024-25 Service Agreements (ABF and Block LHNs) to the Administrator, with New South Wales (NSW), Queensland (Qld) and South Australia (SA) providing partial submissions to date.
Of these submissions, 48 out of 49 Service Agreements received were submitted to the Administrator within the required 14 calendar days from finalisation or amendment.
Of the 49 Service Agreements (ABF LHNs only) submitted to the Administrator, 17 align to current NWAU estimate submissions, compared to 15 out of 30 in September 2023.
Victoria have not yet provided any of the 77 Service Agreements. See Victoria’s historical service agreement submission timeline below:
- 2019-20 – submitted October 2019
- 2020-21 – submitted June 2021
- 2021-22 – submitted May 2022
- 2022-23 – submitted May 2023
Maintenance of Effort
Parties to the Addendum agreed, at a minimum, to maintain levels of funding for public hospital services through the the Pool for 2020-21 to 2024‑25 at not less than the level of funding for 2018-19, while having regard to new, appropriate models of care that may change the setting in which care is delivered (A102).
The assessment of Maintenance of Effort focuses on in-scope public hospital services under the NHR Agreement. Out-of-scope activity is defined as non-hospital services or those public hospital services with a funding source other than the NHR Agreement.
This work has identified some inconsistencies in the level of in-scope and out-of-scope funding transacted through the Pool as well as pricing and activity information published in LHN Service Agreements.
We based the assessment of Maintenance of Effort on in-scope Activity Based Funding only due to data limitations on Block funding. We plan on doing additional work in 2024-25 to enable us to include
in-scope Block funding into future iterations of the report.
The published Maintenance of Effort Reports details:
- the total in-scope ABF public hospital activity that was delivered
- the Price the State set for activity
- the Commonwealth funding entitlement as determined by the Commonwealth Treasurer
- the State funding entitlement (i.e. the balance)
- the State funding contribution transacted through the Pool
The Administrator will continue to work with all Parties to the Addendum towards achieving consistency and transparency in the reporting of public hospital funding (A103). For further details, please visit Annual Report 2022-23 Maintenance of Effort.
Annual report and financial statements
Section 241 of the NHR Act states the Administrator must, within 4 months after the end of each financial year, provide to the responsible Ministers an annual report on the exercise or performance of his or her functions during the financial year.
The annual report includes the following information for the relevant financial year:
- the amounts paid into each State Pool Account and State Managed Fund by the relevant State or Territory, and the basis on which the payments were made
- the amounts paid into each State Pool Account by the Commonwealth and the basis on which the payments were made
- the amounts paid from each State Pool Account to LHNs, a State Managed Fund or other organisations or funds, and the basis on which the payments were made
- the amounts paid from each State Managed Fund to LHNs or other organisations or funds, and the basis on which the payments were made
- the number of public hospital services funded for each LHN in accordance with the activity based funding system
- the number of other public hospital services and functions funded from each State Pool Account or State Managed Fund.
The annual report is accompanied by:
- a financial statement for each State Pool Account
- a financial statement that combines the audited financial statements for each State Pool Account.
The financial statement is audited by the Auditor‑General of that State in accordance with the relevant legislation of that State relating to financial audit by the Auditor‑General.