Organisational structure

Analytics

The Analytics team is responsible for analysing and reporting on IHACPA’s activity data collections and providing insights which will improve data quality, identify variation and inform policy development and implementation. This includes analysing National Hospital Cost Data Collection data, leading analytics for future funding models and developing the National Benchmarking Portal.

Pricing Development

The Pricing Development team works in collaboration with other teams within IHACPA to develop and refine innovative methods for determining prices for public hospital services, aged care services, evidence driven national health policies, alternative health care funding models, and classification systems.

Hospital Pricing

The Hospital Pricing team maintains and builds the pricing models that inform the annual national efficient price and national efficient cost determinations, which in turn inform the funding of Australia’s public hospitals. This work is done in consultation with Australian Government and state and territory governments, as well as clinicians and other stakeholders, and is set out in IHACPA’s pricing framework. The team also develops supporting documentation and tools that explain and help with the application of the price tables and adjustments to health data.

Aged Care Pricing

The Aged Care Pricing team is responsible for developing and refining the pricing models that inform IHACPA’s advice to the Australian Government on pricing for residential aged care, residential respite care and in-home aged care services. This involves understanding and analysing cost and activity data collected from aged care providers through IHACPA’s cost collections and financial reporting, and collaborating with other teams across the agency to develop pricing advice that is evidence-based, transparent and informed by broad stakeholder consultation.

Aged Care Costing

The Aged Care Costing team coordinates the collection, validation and analysis of both financial and service utilisation data for residential and in-home aged care services. This data is collected and analysed to create data sets to show the cost that is required to deliver the aged care services at a client level for both residential and in-home aged care services. To ensure that the costing data for residential and in-home aged care can continue to be a well-informed, evidence-based data collection, the Aged Care Costing team also conduct specific costing studies.

Data Acquisition

The Data Acquisition team works with states and territories to develop appropriate data specifications, and to acquire, validate and maintain data in the IHACPA information technology environment, as well as provide analytical support to various teams.

Data Management

The Data Management team manages IHACPA’s data warehouse, ensuring data is well maintained, accessible and fit for purpose. The section is responsible for handling both external and internal data requests, providing stakeholders with secure and timely access to approved datasets. The team also drives research and development of modern data management techniques, enhancing the data experience for business users by tailoring data quality and structure to meet specific use cases and evolving business needs.

Hospital Costing

The Hospital Costing team coordinates the collection, validation, analysis and reporting of the National Hospital Cost Data Collection (NHCDC) in collaboration with states, territories and private hospitals. To ensure the NHCDC remains a robust and evidence‑based collection, the Hospital Costing team undertakes targeted projects focused on costing, data quality and priority areas.

Infrastructure

The Infrastructure team manages IHACPA’s computing resources used to deliver the national efficient price and national efficient cost, and provides support for technology-based projects.

Acute Care Classification

The Acute Care Classification team refines and maintains the clinical classifications and coding standards that are used to classify admitted care activity in public and private hospitals in Australia:

• International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) – used to classify diseases, injuries and related health problems
• Australian Classification of Health Interventions (ACHI) – used to classify surgeries, therapies and health interventions
• Australian Coding Standards (ACS) – guidelines designed for nationally consistent application of ICD-10-AM and ACHI; collectively known as ICD-10-AM/ACHI/ACS
• Australian Refined Diagnosis Related Groups (AR-DRGs).

The AR-DRG classification groups admitted episodes of care into clinically meaningful and cost coherent groups and is underpinned by ICD-10-AM/ACHI/ACS. 

The classifications are developed in consultation with clinical, technical and jurisdictional stakeholders to ensure they remain current and fit for purpose. 

The ICD-10-AM/ACHI/ACS and AR-DRG classification system underpins the activity based funding framework for public hospital admitted acute care, but also serves multiple other purposes including research, education, epidemiology, health service planning and research into the quality of health care and patient safety.

Classifications

The Classifications team refines, develops and maintains the clinical classifications, coding rules and business rules that are used to classify emergency care, subacute and non-acute care, mental health care, non-admitted care, and teaching and training activity in Australian public hospitals. Specifically, the 5 service categories and the corresponding classification systems include:

• Emergency care
  • Emergency Care ICD-10-AM Principal Diagnosis Short List (EPD Short List)
  • Australian Emergency Care Classification (AECC)
  • Urgency Disposition Groups (UDG).
• Admitted subacute and non-acute care
  • Australian National Subacute and Non-Acute Patient classification (AN-SNAP).
• Mental health care
  • Australian Mental Health Care Classification (AMHCC).
• Non-admitted care
  • Tier 2 Non-Admitted Services Classification (Tier 2).
• Teaching, training and research
  • Australian Teaching and Training Classification (ATTC).

The AECC, AN-SNAP and AMHCC classifications group episodes emergency, subacute or mental health care activity into clinically meaningful cost coherent groups and are underpinned by the ICD-10-AM. While the Tier 2 classification groups episodes into clinically meaningful cost coherent groups based on the nature of the service provided and the type of clinician, and the ATTC groups episodes based on the profession and training stage. 

The classifications are refined and developed in consultation with clinical, technical and jurisdictional stakeholders to ensure they remain current and fit for purpose. Each classification system underpins the activity based funding framework for public hospitals but also serves multiple other purposes including research, education, epidemiology, health service planning and research into the quality of health care and patient safety.

Hospital Policy and Projects 

The Hospital Policy and Projects team develops and refines the policy frameworks that underpin IHACPA’s hospital pricing arrangements. The team leads the implementation of the hospital-specific components of the National Health Reform Agreement, including the Pricing Framework for Australian Public Hospital Services, the National Efficient Price Determination and National Efficient Cost Determination. It also analyses underlying systems and drives continuous improvement in hospital pricing policy.

Policy Development, Alignment and Planning 

The Policy Development, Alignment and Planning team shapes strategic priorities and drives alignment across IHACPA’s policy domains. The team synthesises work streams and policy contexts to identify strategic differences and opportunities for alignment. It also leads policy development and planning a systems perspective, including the development of shared policy principles and strategic directions. 

Aged Care Policy (Residential) and Aged Care Policy (Support at Home)

The Aged Care Policy residential and Support at Home teams develop and review the policies, procedures and frameworks that support the agency in undertaking its role in providing annual aged care pricing advice to the Australian Minister for Health and Ageing. The scope of IHACPA’s annual pricing advice includes residential, respite and in-home aged care services.

IHACPA seeks input from stakeholders on its policy approach, methodology and high-level principles through an annual consultation paper that governs its advice. The resulting Pricing Framework for Australian Aged Care Services is reviewed and updated annually to reflect new costing and pricing priorities and developments.

Through its committee structure IHACPA consults broadly with aged care stakeholders, including aged care providers across the for-profit, not-for-profit and government sectors, providers and aged care recipients in rural and remote locations, as well as peak organisations and industrial bodies, governments, and consumers and their carers. 

Aged Care Policy (Accommodation)

The functions of the Aged Care Policy (Accommodation) team are to review applications for refundable accommodation deposits above the maximum prescribed by the Aged Care Rules 2025. This team also shares information with the Department of Health, Disability and Ageing and the Aged Care Quality and Safety Commission to support their functions, as provided by the Aged Care Act 2024.

Communications 

The Communications team leads IHACPA’s external communications, promoting the agency’s role, functions and work program. They manage IHACPA’s website, social media channels and media relations, and deliver targeted communications and events. The team also provides internal communication services to support IHACPA staff.

Corporate Governance and Compliance

The Corporate Governance and Compliance team provides support and advice on the effective operation of IHACPA’s governance framework. Responsibilities include managing statutory and regulatory compliance (including legislative reporting, risk management, information management, fraud control), and ministerial liaison. In addition, the team oversee office services and provide executive support.

Finance

The Finance team ensures that IHACPA’s financial compliance framework meets the financial related obligations under the Commonwealth’s legislative and policy environment. Their core responsibilities include the management of financial operations including budget submissions and forecasting, preparation of monthly and annual financial statements and the provision of financial and procurement advice including management reporting and managing audit activity.

Human Resources

The Human Resources team manages strategic projects and advises senior management in relation to complex or sensitive HR issues such as organisational change.

Legal 

The Legal team provides advice on legal and regulatory matters arising within IHACPA including the management of legal risk, administrative law advice, policy development, statutory interpretation, contract advice, freedom of information and privacy advice, facilitating training and guidance to assist IHACPA staff in identifying and escalating legal matters   and management of IHACPA’s legal interests including the briefing of external law firms.

Secretariat

The Secretariat team provides secretariat services to the Pricing Authority, committees and working groups and manages general enquiries from stakeholders across the health and aged care sectors. The team also manages enquiries regarding IHACPA’s licensing of the AR DRG classification system.