Responding to the needs of the health system
In 2021, IHPA prioritised undertaking early analysis of the impacts of the COVID-19 pandemic based on 2019–20 activity data to ensure that the national pricing model accurately reflected variations in costs, activity, and how patients access public hospital services.
The analysis of the 2019–20 activity data demonstrated that despite the substantial reduction of hospital episodes in March to June 2020, which coincided with the onset of national lockdowns and the cancellation of elective surgeries, hospital expenditure remained relatively stable throughout the COVID-19 impacted period.
IHPA has conducted extensive consultation with jurisdictions, alongside the analysis of 2019–20 activity data, to inform the key policy considerations that account for the variations in activity and cost data impacting the national pricing model, however it acknowledges that it is not possible to definitively account for the ongoing impacts that COVID-19 may have on hospital service delivery and costs.
IHPA will continue to work closely with jurisdictions and key stakeholders to ensure that the national pricing model continues to reflect variations in activity and cost, and current models of care, ahead of analysing a full financial year of data impacted by the response to the pandemic for 2023–24.
Through this consultation, IHPA is seeking feedback on its approach to accounting for the impacts of COVID-19 on 2020–21 activity and cost data as the agency analyses the assumptions applied in the NEP Determination 2022–23 (which was released in March 2022).
‘While accounting for the impact of COVID-19 will remain a priority for IHPA in developing the 2023–24 Determination, IHPA will consider reinvestigating other initiatives where there is sufficient data available for pricing model refinements,’ said Mr David Tune AO PSM.
IHPA will continue to monitor and assess the longer term impacts of COVID-19 in consultation with jurisdictions and key stakeholders as updated activity and cost data becomes available.
Supporting long-term health reform through future funding models
Mr David Tune AO PSM, Chair of IHPA, invites interested parties to provide feedback on the future direction of health funding reforms that should be considered for 2023–24.
‘The current funding system has the potential to improve continuity of care,’ said Mr David Tune AO PSM. 'IHPA is working towards designing innovative funding approaches that begin to trial the prioritisation of preventing hospitalisations and supporting the delivery of services across multiple settings of care at a community level.'
The Addendum to the National Health Reform Agreement 2020–25 enables IHPA to assess the most effective service response, particularly for patients with complex and chronic health conditions through funding models other than activity based funding, such as bundled payments and capitation models.
Mr David Tune AO PSM notes, ‘We have seen the health sector respond to the needs of communities under immense pressures relating to capacity, restrictions and complex conditions that require tailored interventions – with the support of jurisdictions, and health professionals that are willing to share their feedback through consultations such as this, our investigation into alternative models can be targeted and support initiatives that are patient-centred, and lead to better health outcomes, reduced costs and an improved patient experience.’
The agency is currently considering how the funding model can better support the use of virtual care in patient settings such as emergency departments, specialist access programs and mental health responder programs, as well as care pathways that are not well defined and may extend over many years (for example, chronic kidney disease).
‘We hope to be able to facilitate a move towards programs of care that empower patients, communities and service providers through locally-controlled solutions that take a value-based care approach that is both sustainable and efficient,’ concluded Mr David Tune AO PSM.
While IHPA considers that activity based funding will continue to be the best pricing and funding mechanism for many hospital services, IHPA has commenced engaging with the National Health Reform Agreement Reform Implementation Group, jurisdictions, and the healthcare sector more broadly, to facilitate the implementation of innovative funding models through bilateral agreements with the Commonwealth.
Feedback gathered in this public consultation process will be used to inform the policy decisions in the Pricing Framework for 2023–24, which will be released in December 2022 ahead of the release of the NEP and NEC Determinations 2023–24, which will be released in March 2023.
Submissions can be emailed to firstname.lastname@example.org or posted to PO Box 483, Darlinghurst NSW 1300 by 5pm AEST on Friday 8 July 2022.
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