IHPA Pricing Framework for Public Hospital Services 04 December 2013
The Independent Hospital Pricing Authority (IHPA) has released the Pricing Framework for Australian Public Hospital Services 2014-15. This document provides the key principles, scope and approach to be adopted by IHPA in pricing public hospital services from 1 July 2014.
The VHA sent a submission to IHPA on behalf of our members in July this year. The 2014-15 Pricing Framework supports many of the views in our submission, which is referenced in the IHPA document.
Community-based older persons mental health services and addiction medicine clinics will be classified as in-scope public hospital services that are eligible for Commonwealth funding. Home ventilation programs will be eligible for inclusion on the General List for 2014-15, however this decision will be reviewed once the full scope of the national disability insurance scheme (NDIS) is known.
IHPA will use AR-DRG V7.0 for setting the national efficient price (NEP) in 2014-15 for acute admitted services but will develop AR-DRG V8.0 to be used for pricing from 2016. In developing AR-DRG V8.0 consideration will be given to the complexity of paediatrics treated in a specialist hospital.
The VHA submission identified several factors contributing to the higher cost of care for paediatric patients, and these will be considered in a review on patient complexity and comorbidity, which will inform the development of AR-DRG V8.0.
IHPA’s approach to pricing of mental health services (acute admitted and community based) will remain unchanged in 2014-15. However, IHPA is working towards implementation of the new Australian Mental Health Classification by 1 July 2016.
Outreach activity and cost will be allocated to the originating service. Telehealth activity will continue to be counted at the service provider end but this may change in future years.
For very long-stay patients, IHPA proposes that patients staying more than 200 days as at 30 June each year will be assigned a provisional National Weighted Activity Unit (NWAU) value. The NWAU value is based on the average high outlier per diem rate for the care type for which the patient is admitted (acute or subacute).
On discharge, the provisional NWAU value assigned to the patient in previous years will be subtracted from the actual NWAU value calculated at the time of discharge . IHPA will release the business rules to support the calculations of provisional NWAUs in the first quarter of 2014, for implementation from 1 July 2014.
An intensive care unit (ICU) adjustment will be applied from 1 July 2014. Eligible ICUs will be identified based on a measure of their size and the overall complexity of their patients. Details of the criteria for determining eligible ICUs will be published in the 2014-15 NEP Determination in February 2014.
There will be an adjustment for radiotherapy from 1 July 2014.
IHPA will release a discussion paper on options for incorporating safety and quality into public hospital pricing in early 2014.
For a summary of the changes and future work proposed by IHPA please read our Member Bulletin
The Pricing Framework for Australian Public Hospital Services 2014-15 can be accessed via the IHPA website
Tomorrow belongs to those who prepare for it today - Part I 13 November 2013
CSIRO Deputy CEO: Science, Strategy and People Craig Roy explains 6 megatrends that will shape our world over the next 20 years.
Tomorrow belongs to those who prepare for it today - Part II 12 November 2013
Director of the CSIRO's Preventative Health Flagship, Professor Lynne Cobiac, explains how these six megatrends will impact human health and healthcare systems.
The role of boards in clinical governance: new research 11 November 2013
The results of clinical governance research conducted by Melbourne University and jointly funded by the VHA and the VMIA have been published by the Australian Healthcare and Hospitals Association (AHHA).
The research paper entitled ‘The role of boards in clinical governance: activities and attitudes among members of public health service boards in Victoria’ is published in the AHHA’s Australian Health Review (AHR) volume 37 no 5.
The research investigated the attitudes of board members from 82 Victorian health service boards in relation to quality and safety of care. The findings highlight areas for further board development in data reporting and benchmarking, which the VHA aims to address via future advocacy and project work.
The authors - Professor David Studdert, Senior Research Fellow Marie Bismark and Research Assistant Simon Walter - conclude that, collectively, health service boards are engaged in an impressive range of clinical governance activities. However, the extent of engagement is uneven across boards, certain knowledge deficits are evident, and there is wide agreement among board members that further training in quality-related issues would be useful.
While this research is hospital-based, the issues raised have relevance to community health boards from a process perspective.
Quo vadis for the next 10 years for health and medical research? 18 October 2013
CSIRO Board Chair Simon McKeon discusses the findings of the McKeon Review and argues for stronger connections between health and medical research, and the delivery of healthcare services.
Activity-based funding in Victoria turns 20 – where to next? 18 October 2013
Dr Stephen Duckett asks what have we learned from the implementation of activity-based funding, and where do we go from here?
Congratulations Western District Health Service 17 October 2013
Western District Health Service (WDHS) has won the VHA's 2013 Annual Award for telehealth services in oncology, urology and pain management.
WDHS has also won our inaugural Member’s Choice Award, voted for by delegates at the annual conference Celebrating 75 years: Meeting the challenges ahead.
These awards recognise outstanding health service initiatives that challenge existing norms in service provision to deliver improved patient outcomes.
Award sponsor HardyGroup International presented the winner’s trophy to WDHS at the VHA’s annual conference on 17 October.
WDHS has been an early adopter of telehealth, establishing three clinical services since August 2012. Its urology and pain management telehealth programs are among the first of their kind in Victoria.
Telehealth has increased patient access and reduced waiting times for these services. It has also saved about 75,000 km in travel by patients and specialists, and up to $48,000 in associated travel costs.
Most WDHS telehealth patients are elderly and isolated, with limited access to transport and income. Previously, they had to travel to Melbourne, Ballarat or Geelong (a 500 kilometre return trip) or their specialists had to travel to Hamilton.
The telehealth program has required participating health services to embrace new models of care. Melbourne Health’s Royal Melbourne Hospital provides pain clinics, while Barwon Health provides oncology and urology clinics.
Telehealth has also enabled WDHS to double the number of students on placement within its speech department, and students are now reporting an improved placement experience.
Previously, students were personally supervised by a speech therapist, but evidence showed that the presence of an observer could distort the dynamics of a speech therapy session, and affect the behaviour and performance of participants.
One-to-one supervision was also time consuming for the WDHS speech pathologist, who can now remotely supervise two students at a time.
2013 Annual Award finalists show great innovation 17 October 2013
Congratulations to all entrants in our 2013 Annual Awards, particularly the following finalists:
- Gippsland Lakes Community Health Active Lorikeets program, providing allied healthcare for preschoolers with speech and fine motor difficulties
- Nillumbik Health planned activity group for people aged under 65 with early onset dementia
- The Royal Women’s Hospital caseload (one-to-one) midwifery model for expectant mothers aged 13-19
- Ovens and King Community Health Service continence self-management program
VHA Chairman Anthony Graham said all entries in the 2013 Annual Awards showed a high level of innovation.
"The VHA believes the capacity for innovation in our healthcare sector derives directly from Victoria’s devolved model of governance," he said.
"Devolved governance allows innovators in local settings to communicate their ideas directly to their executive teams and, ultimately, to their boards of governance."
Community Health Australia - video 01 October 2013
Community Health Australia (CHA) is a new entity of the VHA and a founding member of the International Federation of Community Health Centres (IFCHC). The IFCHC's Australian launch took place at our annual conference on October 18.
Other IFCHC members include the American National Association for Community Health Centres (NACHC), the Canadian Association of Community Health Centres (CACHC), and the European Forum for Primary Care (EFPC).
Read our Bulletin or watch the CHA video.
Federal election update 09 September 2013
On Saturday 7 September 2013, the Australian people elected the Liberal National Coalition to government.
Despite health policy not being a central issue in this federal election, the VHA was active in engaging the major parties to discuss matters of importance for VHA members and for the Victorian healthcare system.
The VHA looks forward to engaging with the government elect and the federal opposition to advance the interests of our members and to strive for improvement in the Victorian healthcare system.
VHA launches project to support public aged care providers with reform 06 September 2013
The Victorian Healthcare Association (VHA) has recieved funding from the Victorian Department of Health to support Victorian Public Health Services and Incorporated Associations operating Public Sector Residential Aged Care Services (PSRACS) to prepare for the implementation of the Commonwealth's Living Longer Living Better aged care regulatory changes.
In order to achieve this, the VHA will lead a sector directed program of initiatives aimed at assisting the public provider community to effectively respond and adapt to the risks and opportunities presented by the changing regulatory and financial environment.
Over the next few weeks we will be preparing a more detailed project plan and putting in place a steering group, before commencing briefings and consultations.
If you have any questions or wish to discuss this project, please contact us by phone on (03) 9094 7777 or by email at email@example.com
Peak bodies write to Prime Minister over FBT changes 14 August 2013
Four Victorian peak bodies have written to Prime Minister Kevin Rudd, expressing concern over proposed changes to FBT arrangements for leased vehicles and company cars.
The Victorian Healthcare Association (VHA), Leading Aged Services Australia (LASA) Victoria, Ambulance Victoria and the Australian Dental Association predict that public and not-for-profit sector employees with leased vehicles will lose up to $2,500 a year from their salary package under the changes.
Salary packaging of vehicle expenses is common for nurses, paramedics, aged care workers, doctors, and allied health workers.
"As with other salary sacrifice arrangements, access to vehicle fringe benefits is a necessary means to increase the competitiveness of remuneration in these roles," the joint letter states."Benefits of this type are of particular importance for positions in rural areas, where recruitment and retention can be challenging."
Figures released by the Australian Salary Packaging Industry Association (ASPIA) suggest the average employee with a vehicle lease arrangement earns around $70,000 and their vehicle is worth $34,500.
Of 100,000 individuals reviewed by the ASPIA, 28 per cent worked in the charity or public health sectors, 21 per cent were police or teachers, 33 per cent were state or federal public servants, and only 18 per cent worked in the private sector.
"Initial feedback from our member organisations suggests that the impact of the changes on individual staff will be as high as $2,500 per year. This equates to an annual total of $20 million across the Victorian public health sector alone," the joint letter states.
"We are particularly concerned that the announcement was made with no notice or consultation, and without consideration of the unintended consequences, particularly for public sector and not-for-profit employers and employees."
Navigating the reforms to not-for-profit laws 07 August 2013
Russell Kennedy Lawyers, a major sponsor of the VHA, has launched NFPinsight – a website to support charities and not-for-profit organisations currently facing sector-wide reforms.For the first time in decades, substantial legislative and policy reforms are affecting charities and NFPs. The Australian Charities and Not-for-Profits Commission will be introducing new governance standards, financial reporting regulations and external conduct standards across the sector.
- an overview of reforms affecting the sector
- important dates and deadlines for charities and NFPs
- guidance on how to prepare for the changes
- Russell Kennedy articles, events and speaker engagements relevant to NFPs
- useful links to a variety of government and other resources
For further information visit NFPinsight
Bridging the health system - developing an effective primary/acute interface 05 August 2013
The VHA 'Bridging the health system - Developing an effective primary/acute interface' conference took place over Wednesday 31 July and Thursday 1 August.
Highlights included the announcement of the International Federation of Community Health Centres and Community Health Australia, and a range of excellent speakers and presentations.
Copies of presentations are available on our Events page
VHA responds to IHPA paper on hospital pricing 30 July 2013
The Independent Hospital Pricing Authority (IHPA) has released a consultation paper to inform work for the 2014-15 pricing framework for public hospital services. This paper will also inform the determination of the national efficient price (NEP) and the national efficient cost (NEC).
The VHA's response to IHPA emphasises the need for an integrated hospital system that aligns the most timely, least costly, quality services directly with consumer needs.
Over many years, Victoria has shifted services away from acute settings and towards primary and community settings, in cases where this can be done safely and effectively at a more efficient price.
The VHA is concerned that designating services to fall under different purchasers could restrict the exploration of healthcare solutions in different settings. This may have the unintended consequence of obstructing innovation in the delivery of healthcare.
VHA opposes cap on training expenses 12 July 2013
The VHA believes a proposed $2,000 cap on self-education and training expenses will discourage professional development in the healthcare sector, resulting in risks to patient safety and clinical outcomes.
To maintain service standards, the health workforce must undertake continual professional development and training, particularly in small rural communities where the recruitment and retention of skilled health professionals is a challenge.
The viability of many rural communities strongly correlates to the level of healthcare available within that community. The VHA believes a cap on education and training expenses could lead to poorer health outcomes and undermine the sustainability of these important rural communities.
"The health sector relies heavily on education and training to maintain a skilled and current workforce, which in turn results in better care and clinical outcomes for patients," VHA Chief Executive Trevor Carr says.
"The health and wellbeing of Australian patients should not be put at risk in order to deliver budget savings. The VHA accepts that abuses of the current tax deductions should be addressed but believes that the proposed changes will be detrimental to the health system."
Federal budget hands back $107m to Victoria 21 May 2013
More than $100 million that was to be cut from Victorian hospital budgets has been reinstated in the 2013-14 federal budget.
The Commonwealth had intended to cut $107 million from Victorian hospitals this financial year, following changes in the way it estimates population growth. The VHA successfully campaigned for the Commonwealth to reverse this year's cut, however Victoria still stands to lose $368 million over the next three years. The VHA will continue to lobby for this future funding to be reinstated.
Also in the 2013-14 federal budget, $14.9 billion has been committed over the next seven years to establish the National Disability Insurance Scheme (DisabilityCare Australia).
To fund this scheme, the Medicare Levy will increase from 1.5% to 2% from 1 July 2014. This proposed increase to the levy will have a consequential impact on other tax rates, including the fringe benefit tax (FBT). From 1 April 2014, the FBT rate will increase from 46.5% to 47%. For employees working in the public health sector or for Public Benevolent Institutes (PBI), this will reduce, although only slightly, the amount that can be packaged for threshold benefits.
In 2013-14, the Government will provide $33.8 million to the General Practice Rural Incentives Program (GPRIP) to encourage medical practitioners to work in rural, regional and remote areas.
There will also be $6 million in 2013-14 to continue the Workforce Redesign Program to address shortages and improve the effectiveness and efficiency of the health workforce through innovative pilot projects and training.
Over the next two years, $10 million will be spent on a national communications campaign to outline the benefits of Medicare rebates and safety nets, electronic Medicare claiming, e-Health records, Medicare Locals and the after-hours GP helpline.
The budget also commits $226.4 million to reinforcing Australia’s position as a global leader in cancer research, prevention and treatment.
VHA policies supported in state budget 16 May 2013
The 2013-14 state budget delivered a modest increase to healthcare of $661 million, or 4.8 per cent. This included $426 million in new healthcare initiatives, although $53 million of this funding was redirected from other service areas.
Several of the VHA's key budget recommendations received funding support, including:
• Funding of asset depreciation has not changed as recommended, however we are pleased with the Government’s investment of $60 million into the replacement of statewide infrastructure and medical equipment
• The community-based ambulatory care centre and health and medical precinct were elements of major VHA submissions in 2012-13. We are pleased to note that the Government has allocated $18.2 million over the forward estimates for the development of the clinic
• Providing secondary care in community settings was also recommended by the VHA and will be a focus of the community-based ambulatory care centre
• Training for rural GP proceduralists will receive a $3 million boost in funding
• Clinical training for undergraduate and postgraduate students has also received a boost in funding with $235.5 million allocated to various clinical training programs over the next four years
• The Home and Community Care program will receive $140 million to increase support for older and younger Victorians with a disability
• The Integrated Health Promotion program has had its expected 13% funding cut overturned, a key point raised in the VHA’s Pre-Budget Submission and in meetings with the Minister for Health and the Department of Health.
Rural Allied Health CPD's now open 01 May 2013
Scholarships are now open to allied health practitioners working in rural Victorian public health services.
The Rural Allied Health Practitioners Subsidy Program is administered by the VHA on behalf of the Victorian Department of Health.