{ "entity_id": "B-004115", "folder": "Independent-Health-and-Aged-Care-Pricing-Authority-Clinical-Advisory-Committee", "name": "Independent Health and Aged Care Pricing Authority Clinical Advisory Committee", "type": "Statutory Body", "jurisdiction": "Commonwealth", "portfolio": "Health, Disability and Ageing", "website": "https://www.ihacpa.gov.au/", "data_status": "rich", "completeness": { "has_strategy_brief": true, "has_strategy_structured": true, "has_vision": false, "has_kpi_targets": true, "has_kpi_results": true, "has_strategy_overview": true, "has_legislation_text": true, "has_legislation_structured": false, "has_global_initiatives_text": false, "has_ideas": true, "has_artifacts": true, "n_ideas": 12, "n_legislation": 0, "n_artifacts": 14, "n_kpi_targets": 2, "n_kpi_results": 2, "n_outcomes": 2, "verified_own_data": true }, "strategy_profile": { "status": "published", "confidence": "high", "summary": "IHACPA’s role pertaining to pricing and funding for public hospital services includes: determining the national efficient price (NEP) for health care services provided by public hospitals where the services are funded on an activity basis; determining the national efficient cost (NEC) for health care services provided by public hospitals where the services are block funded; developing block funding criteria and determining which hospitals, services and functions are eligible for block funding or a combination of activity based funding (ABF) and block funding; developing and specifying classification systems for health care and other services provided by public hospitals; determining adjustments to the NEP to reflect legitimate and unavoidable variations in the costs of delivering health care services; determining data requirements and data and coding standards to apply in relation to data to be provided by jurisdictions, including: data and coding standards to support uniform provision of data; and requirements and standards relating to patient demographic characteristics and other information relevant to classifying, costing and paying for public hospital functions; except where otherwise agreed between the Commonwealth and a state or territory – determining the public hospital functions that are to be funded in the state or territory by the Commonwealth. IHACPA’s role pertaining to the provision of advice on aged care costing and pricing matters to the Australian Government Minister for Health and Aged Care includes: providing aged care pricing advice about changes in the cost of care and methods for calculating amounts of subsidies to be paid for aged care services, for consideration in Australian Government funding decisions; reviewing data, conducting studies and undertaking consultation for the purpose of providing aged care costing and pricing advice; performing such functions as conferred by the Aged Care Act 1997 (the Aged Care Act) or the Aged Care (Transitional Provisions) Act 1997; performing other functions relating to aged care (if any) specified in regulations; undertaking other actions incidental or conducive to the performance of the above functions. [CP p.6]", "official_site_url": "https://www.ihacpa.gov.au/", "source_documents": [ { "type": "corporate_plan", "title": "Download IHACPA Work Program and Corporate Plan 2024-25", "url": "https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf", "period": "2024-25", "confidence": "high" }, { "type": "strategie", "title": "Data Request Form", "url": "https://www.ihacpa.gov.au/sites/default/files/2025-09/data_request_form_version_8.0.pdf", "period": "2025", "confidence": "medium" }, { "type": "strategie", "title": "Download Pricing Framework for Australian Public Hospital Services 2026–27", "url": "https://www.ihacpa.gov.au/sites/default/files/2026-01/Pricing_Framework_for_Australian_Public_Hospital_Services_2026-2027_2.PDF", "period": "2026-27", "confidence": "medium" }, { "type": "strategie", "title": "Download Pricing Framework for Australian Public Hospital Services 2026–27 – Consultation Report", "url": "https://www.ihacpa.gov.au/sites/default/files/2025-12/pricing_framework_for_australian_public_hospital_services-consultation_report_1.pdf", "period": "2026-27", "confidence": "medium" }, { "type": "strategie", "title": "Download Pricing Framework for Australian Public Hospital Services 2025-26", "url": "https://www.ihacpa.gov.au/sites/default/files/2024-12/pricing_framework_for_australian_public_hospital_services_2025-26.pdf", "period": "2025-26", "confidence": "medium" }, { "type": "strategie", "title": "Download Pricing Framework for Australian Public Hospital Services 2025-26 - Consultation Report", "url": "https://www.ihacpa.gov.au/sites/default/files/2024-12/pricing_framework_for_australian_public_hospital_services_2025-26-consultation_report.pdf", "period": "2025-26", "confidence": "medium" }, { "type": "strategie", "title": "Download Pricing Framework for Australian Public Hospital Services 2024-25", "url": "https://www.ihacpa.gov.au/sites/default/files/2024-01/IHACPA-pricing-framework-australian-public-hospital-services-2024-25_1.pdf", "period": "2024-25", "confidence": "medium" }, { "type": "strategie", "title": "Download Pricing Framework for Australian Public Hospital Services 2024-25 - Consultation Report", "url": "https://www.ihacpa.gov.au/sites/default/files/2023-12/IHACPA-pricing-framework-australian-public-hospital-services-2024-25-consultation-report.PDF", "period": "2024-25", "confidence": "medium" }, { "type": "strategie", "title": "Download Pricing Framework for Australian Public Hospital Services 2023-24", "url": "https://www.ihacpa.gov.au/sites/default/files/2022-12/pricing_framework_for_australian_public_hospital_services_2023-24_-_final.pdf", "period": "2023-24", "confidence": "medium" }, { "type": "strategie", "title": "Download Pricing Framework for Australian Public Hospital Services 2023-24 - Consultation Report", "url": "https://www.ihacpa.gov.au/sites/default/files/2022-12/Pricing%20Framework%20for%20Australian%20Public%20Hospital%20Services%202023-24%20-%20Consultation%20Report%20-%20Final.PDF", "period": "2023-24", "confidence": "medium" }, { "type": "strategie", "title": "Download Pricing Framework for Australian Public Hospital Services 2022-23", "url": "https://www.ihacpa.gov.au/sites/default/files/2022-08/pricing_framework_for_australian_public_hospital_services_2022-23.pdf", "period": "2022-23", "confidence": "medium" }, { "type": "strategie", "title": "Download Pricing Framework for Australian Public Hospital Services 2022-23 - Consultation Report", "url": "https://www.ihacpa.gov.au/sites/default/files/2022-08/pricing_framework_for_australian_public_hospital_services_2022-23_-_consultation_report.pdf", "period": "2022-23", "confidence": "medium" }, { "type": "strategie", "title": "Download Pricing Framework for Australian Public Hospital Services 2021–22", "url": "https://www.ihacpa.gov.au/sites/default/files/2022-02/Pricing%20Framework%20for%20Australian%20Public%20Hospital%20Services%202021%E2%80%9322.pdf", "period": "2021-22", "confidence": "medium" } ], "purpose": { "text": "IHACPA’s role pertaining to pricing and funding for public hospital services includes: determining the national efficient price (NEP) for health care services provided by public hospitals where the services are funded on an activity basis; determining the national efficient cost (NEC) for health care services provided by public hospitals where the services are block funded; developing block funding criteria and determining which hospitals, services and functions are eligible for block funding or a combination of activity based funding (ABF) and block funding; developing and specifying classification systems for health care and other services provided by public hospitals; determining adjustments to the NEP to reflect legitimate and unavoidable variations in the costs of delivering health care services; determining data requirements and data and coding standards to apply in relation to data to be provided by jurisdictions, including: data and coding standards to support uniform provision of data; and requirements and standards relating to patient demographic characteristics and other information relevant to classifying, costing and paying for public hospital functions; except where otherwise agreed between the Commonwealth and a state or territory – determining the public hospital functions that are to be funded in the state or territory by the Commonwealth. IHACPA’s role pertaining to the provision of advice on aged care costing and pricing matters to the Australian Government Minister for Health and Aged Care includes: providing aged care pricing advice about changes in the cost of care and methods for calculating amounts of subsidies to be paid for aged care services, for consideration in Australian Government funding decisions; reviewing data, conducting studies and undertaking consultation for the purpose of providing aged care costing and pricing advice; performing such functions as conferred by the Aged Care Act 1997 (the Aged Care Act) or the Aged Care (Transitional Provisions) Act 1997; performing other functions relating to aged care (if any) specified in regulations; undertaking other actions incidental or conducive to the performance of the above functions. [CP p.6]", "source_url": "https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf", "source_page": 6, "source_deep_url": "https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf#page=6" }, "vision": null, "strategic_priorities": [ { "title": "Perform pricing functions", "description": "Perform pricing functions", "source_url": "https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf", "source_page": 7, "source_deep_url": "https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf#page=7" }, { "title": "Refine and develop hospital and aged care activity classification systems", "description": "Refine and develop hospital and aged care activity classification systems", "source_url": "https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf", "source_page": 7, "source_deep_url": "https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf#page=7" }, { "title": "Refine and improve hospital and aged care costing", "description": "Refine and improve hospital and aged care costing", "source_url": "https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf", "source_page": 7, "source_deep_url": "https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf#page=7" }, { "title": "Determine data requirements and collect data", "description": "Determine data requirements and collect data", "source_url": "https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf", "source_page": 7, "source_deep_url": "https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf#page=7" }, { "title": "Investigate and make recommendations concerning cost-shifting and cross-border disputes", "description": "Investigate and make recommendations concerning cost-shifting and cross-border disputes", "source_url": "https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf", "source_page": 7, "source_deep_url": "https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf#page=7" }, { "title": "Conduct independent and transparent decision-making and engage with stakeholders", "description": "Conduct independent and transparent decision-making and engage with stakeholders", "source_url": "https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf", "source_page": 7, "source_deep_url": "https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf#page=7" } ], "values": [ { "name": "integrity", "description": "", "source_url": "https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf", "source_page": null }, { "name": "transparency", "description": "", "source_url": "https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf", "source_page": null }, { "name": "expertise", "description": "", "source_url": "https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf", "source_page": null }, { "name": "collaboration", "description": "", "source_url": "https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf", "source_page": null } ], "outcomes": [ { "name": "Outcome 1: Efficient pricing for public hospital services", "description": "IHACPA’s role is to determine the national efficient price (NEP) and national efficient cost (NEC) for public hospital services, develop block funding criteria, and develop and specify classification systems for health care services provided by public hospitals.", "activities": [ "Development of the Pricing Framework for Australian Public Hospital Services", "Determination of in-scope public hospital services eligible for Commonwealth funding", "National Efficient Price and National Efficient Cost Determinations for public hospital services" ], "source_url": "https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf", "source_page": 9, "source_deep_url": "https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf#page=9" }, { "name": "Outcome 2: Efficient pricing for aged care services", "description": "IHACPA’s role is to provide pricing advice for residential aged care services, including the development of the Pricing Framework for Australian Residential Aged Care Services.", "activities": [ "Development of Pricing Frameworks for Australian Aged Care Services", "Aged Care Pricing Advice" ], "source_url": "https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf", "source_page": 13, "source_deep_url": "https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf#page=13" } ], "performance_measures": [ { "code": "NEP01", "measure": "National Efficient Price Determination", "target": "Stability or improvement", "latest_result": "Target met", "status": "Achieved", "target_source_url": "https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf", "target_source_page": 9, "result_source_url": "", "result_source_page": 35 }, { "code": "NEC01", "measure": "National Efficient Cost Determination", "target": "Stability or improvement", "latest_result": "Target met", "status": "Achieved", "target_source_url": "https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf", "target_source_page": 9, "result_source_url": "", "result_source_page": 35 } ], "document_alignment_terms": { "must_support": [ "IHACPA’s role pertaining to pricing and funding for public hospital services includes: determining the national efficient price (NEP) for health care services provided by public ho", "Perform pricing functions", "Refine and develop hospital and aged care activity classification systems", "Refine and improve hospital and aged care costing", "Determine data requirements and collect data", "Investigate and make recommendations concerning cost-shifting and cross-border disputes", "Conduct independent and transparent decision-making and engage with stakeholders" ], "watch_terms": [ "National Efficient Price Determination", "National Efficient Cost Determination" ], "avoid_claiming_without_evidence": [] }, "review_note": "" }, "strategy_brief_md": "# Independent Health and Aged Care Pricing Authority Clinical Advisory Committee — Strategy Brief\n\n**Reporting period**: 2024-25\n**Corporate plan in force**: 2024-25\n**Corporate Plan**: [2024-25](https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf)\n\n## Our purpose / purposes\n\n> IHACPA’s role pertaining to pricing and funding for public hospital services includes: determining the national efficient price (NEP) for health care services provided by public hospitals where the services are funded on an activity basis; determining the national efficient cost (NEC) for health care services provided by public hospitals where the services are block funded; developing block funding criteria and determining which hospitals, services and functions are eligible for block funding or a combination of activity based funding (ABF) and block funding; developing and specifying classification systems for health care and other services provided by public hospitals; determining adjustments to the NEP to reflect legitimate and unavoidable variations in the costs of delivering health care services; determining data requirements and data and coding standards to apply in relation to data to be provided by jurisdictions, including: data and coding standards to support uniform provision of data; and requirements and standards relating to patient demographic characteristics and other information relevant to classifying, costing and paying for public hospital functions; except where otherwise agreed between the Commonwealth and a state or territory – determining the public hospital functions that are to be funded in the state or territory by the Commonwealth. IHACPA’s role pertaining to the provision of advice on aged care costing and pricing matters to the Australian Government Minister for Health and Aged Care includes: providing aged care pricing advice about changes in the cost of care and methods for calculating amounts of subsidies to be paid for aged care services, for consideration in Australian Government funding decisions; reviewing data, conducting studies and undertaking consultation for the purpose of providing aged care costing and pricing advice; performing such functions as conferred by the Aged Care Act 1997 (the Aged Care Act) or the Aged Care (Transitional Provisions) Act 1997; performing other functions relating to aged care (if any) specified in regulations; undertaking other actions incidental or conducive to the performance of the above functions. [CP p.6](https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf#page=6) [[CP p.6](https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf#page=6)(https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf#page=6)]\n\n## Government priorities for this department\n\n- Perform pricing functions [[CP p.7](https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf#page=7)(https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf#page=7)]\n- Refine and develop hospital and aged care activity classification systems [[CP p.7](https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf#page=7)(https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf#page=7)]\n- Refine and improve hospital and aged care costing [[CP p.7](https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf#page=7)(https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf#page=7)]\n- Determine data requirements and collect data [[CP p.7](https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf#page=7)(https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf#page=7)]\n- Investigate and make recommendations concerning cost-shifting and cross-border disputes [[CP p.7](https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf#page=7)(https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf#page=7)]\n- Conduct independent and transparent decision-making and engage with stakeholders [[CP p.7](https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf#page=7)(https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf#page=7)]\n\n## Outcomes\n\n### Outcome 1: Efficient pricing for public hospital services\nIHACPA’s role is to determine the national efficient price (NEP) and national efficient cost (NEC) for public hospital services, develop block funding criteria, and develop and specify classification systems for health care services provided by public hospitals. [[CP p.9](https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf#page=9)(https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf#page=9)]\n\n**Key activities:**\n- Development of the Pricing Framework for Australian Public Hospital Services\n- Determination of in-scope public hospital services eligible for Commonwealth funding\n- National Efficient Price and National Efficient Cost Determinations for public hospital services\n\n### Outcome 2: Efficient pricing for aged care services\nIHACPA’s role is to provide pricing advice for residential aged care services, including the development of the Pricing Framework for Australian Residential Aged Care Services. [[CP p.13](https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf#page=13)(https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf#page=13)]\n\n**Key activities:**\n- Development of Pricing Frameworks for Australian Aged Care Services\n- Aged Care Pricing Advice\n\n## Values and principles\n\n- integrity\n- transparency\n- expertise\n- collaboration\n\n## What they will measure themselves on this year (targets from 2024-25 corporate plan)\n\n| Code | Measure | Target | Source |\n|---|---|---|---|\n| NEP01 | National Efficient Price Determination | Stability or improvement | [CP p.9](https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf#page=9)(https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf#page=9) |\n| NEC01 | National Efficient Cost Determination | Stability or improvement | [CP p.9](https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf#page=9)(https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf#page=9) |\n\n## How they performed last year (results from 2024-25 annual report)\n\n| Code | Measure | Result | Status | Source |\n|---|---|---|---|---|\n| NEP01 | National Efficient Price Determination | Target met | Achieved | AR p.35 |\n| NEC01 | National Efficient Cost Determination | Target met | Achieved | AR p.35 |", "strategy_overview_evidence_md": null, "internal_strategy_evidence_md": "# Independent Health and Aged Care Pricing Authority Clinical Advisory Committee - Strategy, Performance, and Operating Profile\n\n**Generated at**: 2026-05-09T22:22:36.667373+00:00\n**Entity ID**: B-004115\n**Entity type**: Statutory Body\n**Jurisdiction**: Commonwealth\n**Portfolio**: Health, Disability and Ageing\n**Website**: https://www.ihacpa.gov.au/\n\n> Draft generated from scraped source material. Treat this as an evidence pack for editorial review, not a final judgement.\n\n## Source Coverage\n\n| Source type | Count |\n|---|---:|\n| corporate-plans | 1 |\n| other-pdfs | 1 |\n| pages | 42 |\n| strategies | 12 |\n\n## Executive Readout\n\n### Purpose\n\n- Commonwealth to states and territories for the\nadditional costs incurred by health services in\nIn response to the Consultation Paper, stakeholders responding to the COVID-19 pandemic.\nsupported retention of the COVID-19 treatment\nadjustment and noted the high volume of COVID-19 The COVID-19 Response – Costing and Pricing\ncases in 2021–22, and requested IHACPA consider Guidelines includes the following measures that\ninclusion of additional AR-DRGs in the adjustment, were reflected in the national pricing model:\nand whether the impact of long COVID requires an\nadjustment. • for the purpose of COVID-19 activity funded\nthrough the NPA, the intensive care unit\n(ICU) loading will apply to any patient with a\nCOVID-19 diagnosis code and ICU hours\nreported in the admitted patient care activity\ndata set\nIHACPA Pricing Framework for Australian Public Hospital Services 2024–25 18\n Source: `strategies/IHACPA-pricing-framework-australian-public-hospital-services-2024-25_1.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-01/IHACPA-pricing-framework-australian-public-hospital-services-2024-25_1.pdf)`\n- [pages 18,19]\nth services in\nIn response to the Consultation Paper, stakeholders responding to the COVID-19 pandemic.\nsupported retention of the COVID-19 treatment\nadjustment and noted the high volume of COVID-19 The COVID-19 Response – Costing and Pricing\ncases in 2021–22, and requested IHACPA consider Guidelines includes the following measures that\ninclusion of additional AR-DRGs in the adjustment, were reflected in the national pricing model:\nand whether the impact of long COVID requires an\nadjustment. • for the purpose of COVID-19 activity funded\nthrough the NPA, the intensive care unit\n(ICU) loading will apply to any patient with a\nCOVID-19 diagnosis code and ICU hours\nreported in the admitted patient care activity\ndata set\nIHACPA Pricing Framework for Australian Public Hospital Services 2024–25 18\n Source: `strategies/IHACPA-pricing-framework-australian-public-hospital-services-2024-25_1.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-01/IHACPA-pricing-framework-australian-public-hospital-services-2024-25_1.pdf)`\n- The Work Program and Corporate Plan 2024–25 strengthens the alignment between its purpose, strategic\nobjectives and key activities.\n Source: `corporate-plans/2024-25.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf)`\n- The NHR Act requires annual reporting\non strategic objectives and key activities developed for IHACPA’s annual Work Program while the PGPA Act\nspecifies reporting on corporate outcomes and performance measures across 2024–25 to 2027–28.\n Source: `corporate-plans/2024-25.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf)`\n\n### Role and Functions\n\n- As announced in\nthe Federal Budget May 2023–24, the Support at Home Program will be implemented from 1 July 2025.\nj) Aged care accommodation pricing functions under the Aged Care Act 1997\nDeliverable Timeframe\nAssess applications for increases to extra service fees under section 35-1(2) Ongoing\nof the Aged Care Act 1997\nAssess applications for refundable accommodation deposit amounts above Ongoing\nthe Australian Government Minister for Health and Aged Care’s maximum\nunder section 52G-4(5) of the Aged Care Act 1997.\n Source: `corporate-plans/2024-25.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf)`\n- IHACPA’s role pertaining to the provision of advice on aged care costing and pricing matters to the Australian\nGovernment Minister for Health and Aged Care includes:\n• providing aged care pricing advice about changes in the cost of care and methods for calculating amounts\nof subsidies to be paid for aged care services, for consideration in Australian Government funding\ndecisions\n• reviewing data, conducting studies and undertaking consultation for the purpose of providing aged care\ncosting and pricing advice\n• performing such functions as conferred by the Aged Care Act 1997 (the Aged Care Act) or the Aged Care\n(Transitional Provisions) Act 1997\n• performing other functions relating to aged care (if any) specified in regulations\n• undertaking other actions incidental or conducive to the performance of the above functions.\n Source: `corporate-plans/2024-25.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf)`\n- [pages 6,7,8]\ning matters to the Australian\nGovernment Minister for Health and Aged Care includes:\n• providing aged care pricing advice about changes in the cost of care and methods for calculating amounts\nof subsidies to be paid for aged care services, for consideration in Australian Government funding\ndecisions\n• reviewing data, conducting studies and undertaking consultation for the purpose of providing aged care\ncosting and pricing advice\n• performing such functions as conferred by the Aged Care Act 1997 (the Aged Care Act) or the Aged Care\n(Transitional Provisions) Act 1997\n• performing other functions relating to aged care (if any) specified in regulations\n• undertaking other actions incidental or conducive to the performance of the above functions.\n Source: `corporate-plans/2024-25.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf)`\n- 1.1 Purpose\nIHACPA’s role pertaining to pricing and funding for public hospital services includes:\n• determining the national efficient price (NEP) for health care services provided by public hospitals where\nthe services are funded on an activity basis;\n• determining the national efficient cost (NEC) for health care services provided by public hospitals where\nthe services are block funded;\n• developing block funding criteria and determining which hospitals, services and functions are eligible for\nblock funding or a combination of activity based funding (ABF) and block funding;\n• developing and specifying classification systems for health care and other services provided by public\nhospitals;\n• determining adjustments to the NEP to reflect legitimate and unavoidable variations in the costs of\ndelivering health care services;\n Source: `corporate-plans/2024-25.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf)`\n- [Page 21]\n6 Setting the national\nefficient price\nThe Addendum to the National Health Reform – Clause B10 specifies that IHPA will consult\nAgreement 2020–25 (the Addendum) specifies with the Council of Australian Governments\nthat one of the Independent Hospital Pricing Health Council (CHC)3 on changes that\nAuthority’s (IHPA) determinative functions is to materially impact the application of the\ndetermine the national efficient price (NEP) for national funding model.\nservices provided on an activity basis in\n– Clauses B37–B40 stipulate that IHPA must\nAustralian public hospitals.\nseek guidance through its Jurisdictional\nAdvisory Committee and provide a\n6.1.\n Source: `strategies/pricing_framework_for_australian_public_hospital_services_2022-23.pdf (https://www.ihacpa.gov.au/sites/default/files/2022-08/pricing_framework_for_australian_public_hospital_services_2022-23.pdf)`\n- The key\nIndependent Health and Aged Care Pricing\ndecisions for the NEP Determination 2023–24 and\nAuthority (IHACPA) and expanding its role to\nthe NEC Determination 2023–24 are outlined in the\ninclude the provision of aged care costing and\nPricing Framework 2023–24.\npricing advice to the Commonwealth Government.\n Source: `strategies/Pricing-20Framework-20for-20Australian-20Public-20Hospital-20Services-202023-24-.pdf (https://www.ihacpa.gov.au/sites/default/files/2022-12/Pricing%20Framework%20for%20Australian%20Public%20Hospital%20Services%202023-24%20-%20Consultation%20Report%20-%20Final.PDF)`\n\n### Strategic Priorities\n\n- Key activities\nThe Independent Health and Aged Care Pricing Authority’s (IHACPA) strategic objectives and the associated key\ndeliverables for 2024–25 are detailed below.\n Source: `corporate-plans/2024-25.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf)`\n- Strategic Objective One: Perform pricing functions\na) Development of the Pricing Framework for Australian Public Hospital Services 2025–26\nDeliverable Timeframe\nComplete the public consultation process for the Pricing Framework for July 2024\nAustralian Public Hospital Services 2025–26.\n Source: `corporate-plans/2024-25.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf)`\n- As announced in\nthe Federal Budget May 2023–24, the Support at Home Program will be implemented from 1 July 2025.\nj) Aged care accommodation pricing functions under the Aged Care Act 1997\nDeliverable Timeframe\nAssess applications for increases to extra service fees under section 35-1(2) Ongoing\nof the Aged Care Act 1997\nAssess applications for refundable accommodation deposit amounts above Ongoing\nthe Australian Government Minister for Health and Aged Care’s maximum\nunder section 52G-4(5) of the Aged Care Act 1997.\n Source: `corporate-plans/2024-25.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf)`\n- [Page 24]\nStrategic Objective Four: Determine data requirements\nand collect data\na) Revision of the Three Year Data Plan\nDeliverable Timeframe\nPublish the Three Year Data Plan 2025–26 to 2026–27.\n Source: `corporate-plans/2024-25.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf)`\n- The NHR Act requires annual reporting\non strategic objectives and key activities developed for IHACPA’s annual Work Program while the PGPA Act\nspecifies reporting on corporate outcomes and performance measures across 2024–25 to 2027–28.\n Source: `corporate-plans/2024-25.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf)`\n- IHACPA will continue to work with the Australian Government Department of Health and Aged Care and key\nstakeholders to support the Prostheses List reforms in 2024–25.\nl) National Disability Insurance Scheme review\nDeliverable Timeframe\nCommence work to reform the National Disability Insurance Scheme pricing July 2025\narrangements\nThe Federal Budget May 2024–25 announced that IHACPA will work with the Department of Social\nServices and the National Disability Insurance Agency to undertake initial work to reform the National\nDisability Insurance Scheme pricing arrangements, including reviewing existing pricing approached and\ndeveloping a pricing data strategy.\n Source: `corporate-plans/2024-25.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf)`\n- The IHACPA Work Program and Corporate Plan for 2024–25 defines IHACPA’s strategic objectives and the\nassociated key deliverables for the 2024–25 reporting period.\n Source: `corporate-plans/2024-25.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf)`\n- 1.2 Strategic objectives and key activities\nThe Work Program and Corporate Plan 2024–25 has six strategic objectives with associated key activities for\ndelivery.\n Source: `corporate-plans/2024-25.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf)`\n- [Page 10]\nc) National Efficient Price and National Efficient Cost Determinations for public hospital\nservices 2025–26\nDeliverable Timeframe\nFinalise decisions on jurisdictional submissions for legitimate and December 2024\nunavoidable cost variations to determine whether adjustments are required\nfor the National Efficient Price Determination 2025−26.\n Source: `corporate-plans/2024-25.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf)`\n- [Page 14]\nThe timeframes for IHACPA’s initial public consultation and development of pricing advice are yet to be confirmed\nand will be informed by the requirements set out by the Australian Government Minister for Health and Aged\nCare.\ni) Aged Care Pricing Advice 2025–26\nDeliverable Timeframe\nProvide pricing advice to inform Australian Government decisions on July 2025\nresidential aged care and respite care funding for 2025–26.\n Source: `corporate-plans/2024-25.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf)`\n\n## KPIs, Targets, and Where They Are At\n\n- IHACPA notes that • is admitted to, or remains in hospital without\ninstability was introduced into activity and cost data its mother.\nfor the years 2019–20, 2020–21 and 2021–22 as a result\nA newborn patient day is considered unqualified if\nof COVID-19.\n Source: `strategies/pricing_framework_for_australian_public_hospital_services_2023-24_-_final.pdf (https://www.ihacpa.gov.au/sites/default/files/2022-12/pricing_framework_for_australian_public_hospital_services_2023-24_-_final.pdf)`\n- IHACPA also public hospital services year on year, which are the\nnotes that costs associated with the health workforce result of significant changes to clinical care and\nare accounted for at a national level through service delivery.\nreporting in the National Hospital Cost Data\nCollection (NHCDC) and thus, cost impacts of To account for the impact of COVID-19 on the\nchanges to the workforce will be accounted for national pricing model for NEP24, IHACPA intends\nwhere reported in national data collections. to:\nIn consultation with jurisdictions, IHACPA has • modify admitted acute activity and cost data\nundertaken detailed analysis to understand and nationally in 2021–22\naccount for the impact of COVID-19 on 2021–22\n• exempt specific end-classes from the National\nactivity and cost data, including significant\nPricing Model Stability Policy.\n Source: `strategies/IHACPA-pricing-framework-australian-public-hospital-services-2024-25-consultatio.pdf (https://www.ihacpa.gov.au/sites/default/files/2023-12/IHACPA-pricing-framework-australian-public-hospital-services-2024-25-consultation-report.PDF)`\n- [pages 17,18,19,20]\ntroduce 2 new Tier 2 classes for hospital based non-admitted VAD services for NEP26, which\nwill result in the development of Tier 2 Version 10.0.\n Source: `strategies/pricing_framework_for_australian_public_hospital_services-consultation_report_1.pdf (https://www.ihacpa.gov.au/sites/default/files/2025-12/pricing_framework_for_australian_public_hospital_services-consultation_report_1.pdf)`\n- IHACPA continues to investigate the Rockwood Clinical Frailty Scale and the Functional Independence Measure\nfor Children (WeeFIM™) as drivers of cost for classification purposes, prior to consideration of inclusion in the\nnational best endeavours data set for future years and will progress this work through the Subacute Care Working\nGroup.\nc) Emergency care\nDeliverable Timeframe\nRelease the Australian Emergency Care Classification Version 1.1 September 2024\nImplement the Emergency Care ICD-10-AM Principal Diagnosis (EPD Short July 2025\nList) Thirteenth Edition\nRefine the data request specifications for emergency virtual care Ongoing\nIn late 2018, IHACPA finalised the Australian Emergency Care Classification (AECC) Version 1.0.\n Source: `corporate-plans/2024-25.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf)`\n- Efficient Cost Determinations for\nStakeholders noted the following considerations in\n2024–25?\nthe development of NEP24:\n• For NEP24, what evidence is available\n• the need for flexibility of the model to classify and\nregarding the clinical management of\nprice new models of care, including\npatients with a COVID-19 diagnosis,\nimprovements in data collection, classification of\nincluding patients in an ICU, to support\nlong COVID, and other sub-specialties such as\nretention of the:\npublic health physicians who provide non-patient\no COVID-19 treatment adjustment specific input\no temporary ICU measure for COVID-19 • the impact of the expiration of the National\npatients Partnership on COVID-19 Response (NPA)\nwhich funded certain costs such as personal\no temporary HAC and AHR measures\nprotective equipment (PPE)\nfor COVID-19 patients?\n• quantification of the cost of delayed or deferred\ncare\n Source: `strategies/IHACPA-pricing-framework-australian-public-hospital-services-2024-25-consultatio.pdf (https://www.ihacpa.gov.au/sites/default/files/2023-12/IHACPA-pricing-framework-australian-public-hospital-services-2024-25-consultation-report.PDF)`\n- [pages 24,25]\nhe highest homelessness rates in Australia,\nmainly as a result of overcrowded housing\n• burden of disease, barriers to care and cross-cultural complexities that affect hospital service delivery\n• remoteness, noting the NT’s First Nations population is substantially more concentrated in remote and very\nremote areas than other jurisdictions\n• language, as 58% of First Nations people in the NT speak a local Indigenous language as their first language,\ncompared with 9.5% nationally.\n Source: `strategies/pricing_framework_for_australian_public_hospital_services_2025-26-consultation_r.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-12/pricing_framework_for_australian_public_hospital_services_2025-26-consultation_report.pdf)`\n- IHACPA’s response\nIHACPA will introduce 2 new Tier 2 classes for hospital based non-admitted VAD services for NEP26, which\nwill result in the development of Tier 2 Version 10.0.\n Source: `strategies/pricing_framework_for_australian_public_hospital_services-consultation_report_1.pdf (https://www.ihacpa.gov.au/sites/default/files/2025-12/pricing_framework_for_australian_public_hospital_services-consultation_report_1.pdf)`\n- As announced in\nthe Federal Budget May 2023–24, the Support at Home Program will be implemented from 1 July 2025.\nj) Aged care accommodation pricing functions under the Aged Care Act 1997\nDeliverable Timeframe\nAssess applications for increases to extra service fees under section 35-1(2) Ongoing\nof the Aged Care Act 1997\nAssess applications for refundable accommodation deposit amounts above Ongoing\nthe Australian Government Minister for Health and Aged Care’s maximum\nunder section 52G-4(5) of the Aged Care Act 1997.\n Source: `corporate-plans/2024-25.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf)`\n- Stakeholders noted that COVID-19 had led\nincluded feedback on the Addendum to the to an initial reduction in activity levels as a result\nNational Health Reform Agreement 2020–25 of suspension of elective surgery and some\n(the Addendum).\n Source: `strategies/Pricing-20Framework-20for-20Australian-20Public-20Hospital-20Services-202021-E2-.pdf (https://www.ihacpa.gov.au/sites/default/files/2022-02/Pricing%20Framework%20for%20Australian%20Public%20Hospital%20Services%202021%E2%80%9322.pdf)`\n- [pages 8,9,10,11]\nof Impact\nmust be timely in relation to the matter\nNote: Unless otherwise stated, all references to raised and:\n‘the Addendum’ in this Pricing Framework refer to\nthe Addendum to the National Health Reform • include a risk assessment of the\nAgreement 2020–25. proposed changes or adjustments\n• outline appropriate transition\narrangements\n• be informed by consultation with\nthe parties\n• have input from the Administrator of\nthe National Health Funding Pool.\n Source: `strategies/Pricing-20Framework-20for-20Australian-20Public-20Hospital-20Services-202021-E2-.pdf (https://www.ihacpa.gov.au/sites/default/files/2022-02/Pricing%20Framework%20for%20Australian%20Public%20Hospital%20Services%202021%E2%80%9322.pdf)`\n- [Page 46]\nTable 3: Risk factors for each readmission category\nReadmission category\nIHPA Pricing Framework for Australian Public Hospital Services 2021–22 43\nyrujni\nerusserP\n.1\nsnoitcefni\n.2\nsnoitacilpmoc\nlacigruS\n.3\nsnoitacilpmoc\nyrotaripseR\n.4\nmsilobmeobmorht\nsuoneV\n.5\neruliaf\nlaneR\n.6\ngnideelb\nlanitsetniortsaG\n.7\nsnoitacilpmoc\nlacideM\n.8\nmuirileD\n.9\nsnoitacilpmoc\ncaidraC\n.01\nnoitapitsnoC\n.11\ngnitimov\ndna\naesuaN\n.21\nAge group\n✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓\nMajor diagnostic category (MDC)\n✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓\nEmergency admission flag\n✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓\nDiagnosis-related group (DRG)\ntype ✓ ✓ ✓ ✓ ✓ ✓\nGender\n✓ ✓ ✓ ✓\nTransfer status\n✓\nPatient remoteness\n✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓\nIndigenous status\n✓ ✓ ✓\nObesity\n✓\nHospital Acquired Complication\nflag ✓\nICU hours flag\n✓\nMalnutrition\n✓\nShort stay outlier flag\n✓ ✓ ✓\nNumber of procedures in the index\nepisode ✓ ✓ ✓ ✓\nNumber of admissions in the past\nyear ✓ ✓\n Source: `strategies/Pricing-20Framework-20for-20Australian-20Public-20Hospital-20Services-202021-E2-.pdf (https://www.ihacpa.gov.au/sites/default/files/2022-02/Pricing%20Framework%20for%20Australian%20Public%20Hospital%20Services%202021%E2%80%9322.pdf)`\n- Feedback from stakeholders also included\nrecommendations for undertaking the evaluation IHPA will continue to refine the methodology for\nprocess: the evaluation of the implemented safety and\nquality reforms, based on the feedback from\n- target specific outcomes, such as the stakeholders, in consultation with jurisdictions\nnumber, proportion and likelihood of and clinical experts.\nsentinel events, hospital acquired\ncomplications and avoidable hospital\nreadmissions in hospitals pre- and\npost-intervention\nIHPA Pricing Framework for Australian Public Hospital Services 2022–23 – Consultation Report 33\n Source: `strategies/pricing_framework_for_australian_public_hospital_services_2022-23_-_consultation.pdf (https://www.ihacpa.gov.au/sites/default/files/2022-08/pricing_framework_for_australian_public_hospital_services_2022-23_-_consultation_report.pdf)`\n- Stakeholders noted the following cost pressures for\nregional or remote hospitals for consideration in 7.2 Standalone\nthe development of the National Efficient Cost\nhospitals providing\n(NEC) Determination 2023–24 (NEC23):\nspecialist mental\n• rural-specific contracts and enterprise\nagreements health services\n• costs associated with rural workforce\nshortages, including locum and contract staff,\nrecruitment and retention costs, absences\nConsultation question\ndue to coronavirus disease 2019 (COVID-19),\nfly-in fly-out arrangements and\naccommodation • What should IHACPA consider when\ntransitioning standalone hospitals\n• regional and remote specific costs, including\nproviding specialist mental health\npatient transport costs, cost of living and\nservices to ABF?\nhigh cost of specialised services and\nmedications due to limited access\n• lack of access to primary care and higher Feedback received\n Source: `strategies/Pricing-20Framework-20for-20Australian-20Public-20Hospital-20Services-202023-24-.pdf (https://www.ihacpa.gov.au/sites/default/files/2022-12/Pricing%20Framework%20for%20Australian%20Public%20Hospital%20Services%202023-24%20-%20Consultation%20Report%20-%20Final.PDF)`\n- Stakeholders noted the following impacts resulting\nfrom the coronavirus disease 2019 (COVID-19) Western Australia (WA) noted that the national\npandemic response for consideration in the pricing model should not be artificially adjusted to\ndevelopment of the National Efficient Price (NEP) address temporary disruptions without clear and\nDetermination 2024–25 (NEP24): obvious benefits to all states and territories.\n• changes to models of care and demand such as\nReview of the COVID-19 treatment\nincreased provision of health care in\nadjustment\nnon-admitted settings provided by clinical staff\nand flow-on impacts on cost profiles and patient New South Wales (NSW), South Australia (SA), WA,\ncomplexity due to delayed or deferred care, Tasmania and the Australian Medical Association\nincluding elective surgeries (AMA) supported retainment of the COVID-19\ntreatment adjustment.\n Source: `strategies/IHACPA-pricing-framework-australian-public-hospital-services-2024-25-consultatio.pdf (https://www.ihacpa.gov.au/sites/default/files/2023-12/IHACPA-pricing-framework-australian-public-hospital-services-2024-25-consultation-report.PDF)`\n\n## Key Metrics\n\n| Values found | Evidence | Source |\n|---|---|---|\n| $7, 8% | &\n@\nZ\nt\n�\n�\n�\n�\n�\u000e\u0013\u000e.\u000eI\u000ed\u000e\u000e�\u000e�\u000e�\u000e�\u000f \u000f%\u000fA\u000f^\u000fz\u000f�\u000f�\u000f�\u000f�\u0010 \u0010&\u0010C\u0010a\u0010~\u0010�\u0010�\u0010�\u0010�\u0011\u0013\u00111\u0011O\u0011m\u0011�\u0011�\u0011�\u0011�\u0012\u0007\u0012&\u0012E\u0012d\u0012�\u0012�\u0012�\u0012�\u0013\u0003\u0013#\u0013C\u0013c\u0013�\u0013�\u0013�\u0013�\u0014\u0006\u0014'\u0014I\u0014j\u0014�\u0014�\u0014�\u0014�\u0015\u0012\u00154\u0015V\u0015x\u0015�\u0015�\u0015�\u0016\u0003\u0016&\u0016I\u0016l\u0016�\u0016�\u0016�\u0016�\u0017\u001d\u0017A\u0017e\u0017�\u0017�\u0017�\u0017�\u0018\u001b\u0018@\u0018e\u0018�\u0018�\u0018�\u0018�\u0019 \u0019E\u0019k\u0019�\u0019�\u0019�\u001a\u0004\u001a*\u001aQ\u001aw\u001a�\u001a�\u001a�\u001b\u0014\u001b;\u001bc\u001b�\u001b�\u001b�\u001c\u0002\u001c*\u001cR\u001c{\u001c�\u001c�\u001c�\u001d\u001e\u001dG\u001dp\u001d�\u001d�\u001d�\u001e\u0016\u001e@\u001ej\u001e�\u001e�\u001e�\u001f\u0013\u001f>\u001fi\u001f�\u001f�\u001f� \u0015 A l � � �!\u001c!H!u!�!�!�\"'\"U\"�\"�\"�#\n#8#f#�#�#�$\u001f$M$\\|$�$�% %8%h%�%�%�&'&W&�&�&�'\u0018'I'z'�'�(\n(?(q(�(�)\u0006)8)k)�)�*\u0002*5*h*�*�+\u0002+6+i+�+�,\u0005,9,n,�,�-\f-A-v-�-�.\u0016.L.�.�.�/$/Z/�/�/�0 | `pages/corporate-plans-index__02.html (https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf)` |\n| 48 per cent, 26.0 per cent, 12.3 per cent | The analysis of avoidable hospital\n– Option one: Deduct the cost of the\nreadmission episodes by location over the\nreadmission episode from the\nfour year period indicated that:\nindex episode.\n– almost half of all avoidable hospital\n– Option two: Combine the index and\nreadmissions (48 per cent) occurred when\nreadmission episodes and recalculate\npatients presented to the same hospital\nthe funding of the combined episode.\nwithin the same LHN\n– Option | `strategies/Pricing-20Framework-20for-20Australian-20Public-20Hospital-20Services-202021-E2-.pdf (https://www.ihacpa.gov.au/sites/default/files/2022-02/Pricing%20Framework%20for%20Australian%20Public%20Hospital%20Services%202021%E2%80%9322.pdf)` |\n| 2.8 per cent | In reviewing 2015–16,\nunderstanding that currently there is not a 2016–17, 2017–18 and 2018–19 data of all\nnational patient identifier available in national avoidable hospital readmissions within or across\ndata sets used by IHPA. financial years, the analysis revealed that while\nthe majority of readmissions occurred within the\nsame financial year, approximately 2.8 per cent\noccurred across financial years. | `strategies/Pricing-20Framework-20for-20Australian-20Public-20Hospital-20Services-202021-E2-.pdf (https://www.ihacpa.gov.au/sites/default/files/2022-02/Pricing%20Framework%20for%20Australian%20Public%20Hospital%20Services%202021%E2%80%9322.pdf)` |\n| 20 per cent | Guidelines\nThe criteria to select the AR-DRGs for the • application of the ICU adjustment to any\nadjustment was as follows: patient with a COVID-19 diagnosis code in\na non-level 3 ICU\n• the AR-DRG was clinically relevant to the\ntreatment of COVID-19, informed by • exemption of the AHR and HACs\nadvice from IHACPA’s Clinical Advisory adjustment is necessary for episodes of\nCommittee and that at least 20 per cent of care with a COVID-19 diagnosis.\na | `strategies/IHACPA-pricing-framework-australian-public-hospital-services-2024-25-consultatio.pdf (https://www.ihacpa.gov.au/sites/default/files/2023-12/IHACPA-pricing-framework-australian-public-hospital-services-2024-25-consultation-report.PDF)` |\n| 20 per cent, 50 per cent | The\nfor the impact of COVID-19 for future NEP\ncriteria to select the AR-DRGs for the adjustment\nDeterminations.\nwas as follows:\n• the AR-DRG was clinically relevant to the\ntreatment of COVID-19, informed by 4.1.3 Review of the COVID-19\nadvice from IHACPA’s Clinical Advisory Response — Costing and Pricing\nCommittee and that at least 20 per cent of\nGuidelines\nadmissions within that end-class were for\npatients with COVID-19; and\nIn 2020, IHACPA publ | `strategies/IHACPA-pricing-framework-australian-public-hospital-services-2024-25_1.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-01/IHACPA-pricing-framework-australian-public-hospital-services-2024-25_1.pdf)` |\n| 3% | hޜXM�\u0014G\f�O�crٱ]v}Hh% �H�\u0014\u0004�\bBKX�H\br �\\|\u0012���n��T����{����3%H�眸�_N��_IH�@IX�@MDh�%*�@O\u0019X\u0001C�b,�)w�aJ�����\u001a\u000fs\u00122\u001e�$�xT���pME���\n��Su;�Zݏ`j�G(5�#��~,���z\u00067$j\u001aܑTEnIZBtO�\u0015��\u0002�KwUP��*�0���jB5� �=N5\u0004L���\u0014�P����\u001a�z�j�l\u0019U5j�\f����UU\n����\b��r\"l�^�G\u0019���D�=C�/�,V��=Q��� Q'2�6&��(e,�ߖ�v�4�>�W��\"wЊ\"qT\u0015y��W\u00162ݦc,b��\u0006��)U.h\u0019]5\n�S�`.�r�jT0W]5��\u0017\u001d���\u001ct�h#C5��E��m2����g�f\u0010\u0013��N�:����OH�!+��\u0019�Ĥ~\n\u0016�6\"\n�NBd�M���ž���\b\nǬAU\u0013t^T5�\u0011�jҜWy���AU+켚�6\u0018\u0006U�.��Vy��Z���������=MGMk>>U��� | `pages/annual-reports-index.html (https://www.ihacpa.gov.au/sites/default/files/2025-11/ihacpa_annual_report_2024-25_0.pdf)` |\n| $6 | hތX��\u001c7\f}\u0015��ږmI\u0010\u0002��\b�&$�+!\\|%!\u0014J�۾}�%�&���ͬv\\|t$[�ٙ-�RM9\u0015\\|R\u001alFK�4�z*��5RQ2�S��,I����*:��\u0013U�h%Q7�V\u0013�y4J��Gk�5�詉{�ԫ���y�%iT�\u0005����9q1\\/���zM�9#�xν%͎�I���5;p&�\u001d)��Cunް\u0003�R԰�p�h�\u0015�ov`{D�\u0005�����6r֚'=��g;��h��@\u0006`�O�\u0011�{\u000e�c��1(�07�u��1�qu7���n�&���*�RgD�l�1`�.��jX\u001c~�ͰRa�.�R-�\u000bi0ű\u001d�'�\u000e��X�\u0004y�\u0004=A�X4E��i�ɆUD�^=\u0004�k�h-��c\u0011m�u$6��p������);\u001dE4)v::[��ӡ�hb9PF4�\u0001�\u0011����h:�\u0013fK��[�I�6`���D���\u0002s\u001e\u001cLE�[\u0001�̎g�\u0016�\n�Ǥ��kH?\u0016RO��F_B�������m��!}[�tJ���4��EZھ��$������c+-qH_\u0016}T�R\u0016�V | `pages/annual-reports-index.html (https://www.ihacpa.gov.au/sites/default/files/2025-11/ihacpa_annual_report_2024-25_0.pdf)` |\n| $5 | 9��M3$)Ʉ�*>�2���i��(�>��У\u0012K\\|pTU�(sш��h�O6�͎�Q�C\u000e\f��U)\u001e�j\u00199W�(k\u000e8J!e9F��X\u0002\u0016+\u0007��Qj\u0014D�X\u0018��P\u0019��\u0012��V�q�\u0007I��\u0012\u001f%�.�h�q\u0012\u001f5�Z�\u001aN�\u000e�d�CJY�I��3�&}M��I\\|4Vo�)F��X�f��� �[�b5]��\u0011�r��%���9J j�Xl\f\n�`�\"\u0016\u001bC\\|\u0010\u0018C\\|P5��(Z�\f��#\u0012\bV\u0011����\u000bo�\u0018^߼\n�ȩ������O��e\\]����-\u0016A%�\b\u001d\u000b\u0006������\u001f�N�}���\u0019�8)\u001f\"��$rR�\"�~������\u0005�]Ҥ�@\u0012�\u000f$5�g��7��7}��kH�N;��>�z��t��4��9꧇�Ө-7\u000b\f�1�\\�\u000f\u000f\u000f��\u0013�YΞ\np\u0006�3��~{?)h�\u0011��\u0013F�^���euy~�ɤ\"]U\u001f�IxM}��$��>��N�W�\u0001�2��3De{���quy����GW�_�����/y�Q�_��\u001a�+��]�ް%v#uô[��3l�z | `pages/annual-reports-index.html (https://www.ihacpa.gov.au/sites/default/files/2025-11/ihacpa_annual_report_2024-25_0.pdf)` |\n\n## Key Achievements\n\n- As announced in\nthe Federal Budget May 2023–24, the Support at Home Program will be implemented from 1 July 2025.\nj) Aged care accommodation pricing functions under the Aged Care Act 1997\nDeliverable Timeframe\nAssess applications for increases to extra service fees under section 35-1(2) Ongoing\nof the Aged Care Act 1997\nAssess applications for refundable accommodation deposit amounts above Ongoing\nthe Australian Government Minister for Health and Aged Care’s maximum\nunder section 52G-4(5) of the Aged Care Act 1997.\n Source: `corporate-plans/2024-25.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf)`\n- IHACPA continues to investigate the Rockwood Clinical Frailty Scale and the Functional Independence Measure\nfor Children (WeeFIM™) as drivers of cost for classification purposes, prior to consideration of inclusion in the\nnational best endeavours data set for future years and will progress this work through the Subacute Care Working\nGroup.\nc) Emergency care\nDeliverable Timeframe\nRelease the Australian Emergency Care Classification Version 1.1 September 2024\nImplement the Emergency Care ICD-10-AM Principal Diagnosis (EPD Short July 2025\nList) Thirteenth Edition\nRefine the data request specifications for emergency virtual care Ongoing\nIn late 2018, IHACPA finalised the Australian Emergency Care Classification (AECC) Version 1.0.\n Source: `corporate-plans/2024-25.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf)`\n- [pages 23,24,25,26,27,28,29]\ns delivered to private patients in public\nhospitals.\n Source: `strategies/pricing_framework_for_australian_public_hospital_services_2022-23.pdf (https://www.ihacpa.gov.au/sites/default/files/2022-08/pricing_framework_for_australian_public_hospital_services_2022-23.pdf)`\n- Teaching and\nNext steps and future work\ntraining\nIHACPA intends to progress to pricing\ncommunity mental health services using Teaching and training activities are currently block\nAMHCC Version 1.0 for the NEP funded as part of the NEC Determination except\nDetermination 2024–25 (NEP24). where teaching and training is delivered in\nconjunction with patient care (embedded teaching\nIHACPA notes that progression to pricing\nand training), such as ward rounds.\n Source: `strategies/pricing_framework_for_australian_public_hospital_services_2023-24_-_final.pdf (https://www.ihacpa.gov.au/sites/default/files/2022-12/pricing_framework_for_australian_public_hospital_services_2023-24_-_final.pdf)`\n- [Page 23]\nRefinement of existing adjustments\nNext steps and future work\nand development of new\nadjustments\nIHACPA intends to work with its advisory\ncommittees to undertake a program of work\nIn the Consultation Paper on the Pricing Framework\nto investigate and implement these\nfor Australian Public Hospitals 2023–24 (the\nproposed refinements, to inform future NEP\nConsultation Paper), IHACPA signalled its intention\nDeterminations.\nto review 2020–21 activity and cost data to\ndetermine whether sufficient data is available to\nprogress investigation of the following adjustments,\nrecognising the impact of COVID-19 during this\n6.3 Cost pressures\nperiod: review of the Indigenous status adjustment,\nthe Specified Intensive Care Unit and specialised\nchildren’s hospitals eligibility criteria, and For NEP22, IHACPA included an adjustment to\n Source: `strategies/pricing_framework_for_australian_public_hospital_services_2023-24_-_final.pdf (https://www.ihacpa.gov.au/sites/default/files/2022-12/pricing_framework_for_australian_public_hospital_services_2023-24_-_final.pdf)`\n- Qld noted the importance of\nTier 2 classes 40.08 Primary health care and a patient-based approach to classification\n40.11 Social work development.\n• incorporating a tiered funding structure for The QNMU suggested consideration be given to\nhospital pharmacy outpatient consultation how data will be captured in settings that do not use\nservices electronic medical records as part of the ANAPP.\n• greater accuracy in capturing costs for multi-\ndisciplinary case conferencing, the multiple IHACPA’s response\nhealthcare provider indicator, complex services\nfor anaesthesia, medical procedures and Tier 2 Non-Admitted Services Classification\npalliative care, and simulation and planning for\nFor NEP24, IHACPA has consulted with its advisory\nradiation therapy\ncommittees and working groups to include two new\n• account for greater differentiation between classes in Tier 2 for ‘10.22 Subcutaneous\n Source: `strategies/IHACPA-pricing-framework-australian-public-hospital-services-2024-25-consultatio.pdf (https://www.ihacpa.gov.au/sites/default/files/2023-12/IHACPA-pricing-framework-australian-public-hospital-services-2024-25-consultation-report.PDF)`\n- [Page 12]\n3.2 Subacute and\nIHACPA’s decision\nnon-acute care\nFor NEP24, IHACPA intends to progress to\nThe Australian National Subacute and Non-Acute pricing admitted subacute and non-acute\nPatient Classification (AN-SNAP) is used to price patient services using AN-SNAP Version 5.0,\nadmitted subacute and non-acute services. following two years of shadow pricing, as\nrequired by the Addendum to the National\nHealth Reform Agreement 2020–25 (the\n3.2.1 AN-SNAP Version 5.0\nAddendum).\n Source: `strategies/IHACPA-pricing-framework-australian-public-hospital-services-2024-25_1.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-01/IHACPA-pricing-framework-australian-public-hospital-services-2024-25_1.pdf)`\n- [Page 30]\n6.3 Virtual models of 6.4 Organ donation,\ncare retrieval and\ntransplantation\nIn the Consultation Paper on the Pricing Framework\nfor Australian Public Hospital Services 2023–24,\nIHACPA outlined its intention to investigate In 2018, the Review of the Australian organ\ninnovative models of care and services related to donation, retrieval and transplantation system – Final\nvirtual care, with an initial focus on virtual care Report made two recommendations for IHACPA to\ndelivered by emergency departments. conduct a costing study and classification review of\norgan donation, retrieval and transplantation and of\nFor 2023–24, IHACPA has developed data request non-admitted pre- and post-organ transplantation\nspecifications in consultation with jurisdictions for the care.\nvoluntary collection of emergency virtual care activity\ndata from 1 July 2023.\n Source: `strategies/IHACPA-pricing-framework-australian-public-hospital-services-2024-25_1.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-01/IHACPA-pricing-framework-australian-public-hospital-services-2024-25_1.pdf)`\n- 4.4.2 Tier 2 Non-Admitted Services Classification – documentation\nFeedback received\nNSW, Vic, and WA requested the following updates to Tier 2 documentation:\n• alignment between the Compendium, Definitions Manual and the Metadata Online Registry resources regarding\nboth multidisciplinary clinics and multidisciplinary case conferences\n• clarification of definitions for specialties and professions and what comprises a unique service\n• update to the Definitions Manual to separate community and primary care from non-admitted care provided at\nhospitals\n• update to the name of ‘Subcutaneous Immunoglobulin home delivered’ to ‘Subcutaneous Immunoglobulin home\nadministered’\n• clarification around the Tier 2 classes 40.07 Pre-admission and pre-anaesthesia and 40.59 Postacute care.\n Source: `strategies/pricing_framework_for_australian_public_hospital_services_2025-26-consultation_r.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-12/pricing_framework_for_australian_public_hospital_services_2025-26-consultation_report.pdf)`\n- [pages 8,9,10,11]\nof Impact\nmust be timely in relation to the matter\nNote: Unless otherwise stated, all references to raised and:\n‘the Addendum’ in this Pricing Framework refer to\nthe Addendum to the National Health Reform • include a risk assessment of the\nAgreement 2020–25. proposed changes or adjustments\n• outline appropriate transition\narrangements\n• be informed by consultation with\nthe parties\n• have input from the Administrator of\nthe National Health Funding Pool.\n Source: `strategies/Pricing-20Framework-20for-20Australian-20Public-20Hospital-20Services-202021-E2-.pdf (https://www.ihacpa.gov.au/sites/default/files/2022-02/Pricing%20Framework%20for%20Australian%20Public%20Hospital%20Services%202021%E2%80%9322.pdf)`\n- [Page 46]\nTable 3: Risk factors for each readmission category\nReadmission category\nIHPA Pricing Framework for Australian Public Hospital Services 2021–22 43\nyrujni\nerusserP\n.1\nsnoitcefni\n.2\nsnoitacilpmoc\nlacigruS\n.3\nsnoitacilpmoc\nyrotaripseR\n.4\nmsilobmeobmorht\nsuoneV\n.5\neruliaf\nlaneR\n.6\ngnideelb\nlanitsetniortsaG\n.7\nsnoitacilpmoc\nlacideM\n.8\nmuirileD\n.9\nsnoitacilpmoc\ncaidraC\n.01\nnoitapitsnoC\n.11\ngnitimov\ndna\naesuaN\n.21\nAge group\n✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓\nMajor diagnostic category (MDC)\n✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓\nEmergency admission flag\n✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓\nDiagnosis-related group (DRG)\ntype ✓ ✓ ✓ ✓ ✓ ✓\nGender\n✓ ✓ ✓ ✓\nTransfer status\n✓\nPatient remoteness\n✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓\nIndigenous status\n✓ ✓ ✓\nObesity\n✓\nHospital Acquired Complication\nflag ✓\nICU hours flag\n✓\nMalnutrition\n✓\nShort stay outlier flag\n✓ ✓ ✓\nNumber of procedures in the index\nepisode ✓ ✓ ✓ ✓\nNumber of admissions in the past\nyear ✓ ✓\n Source: `strategies/Pricing-20Framework-20for-20Australian-20Public-20Hospital-20Services-202021-E2-.pdf (https://www.ihacpa.gov.au/sites/default/files/2022-02/Pricing%20Framework%20for%20Australian%20Public%20Hospital%20Services%202021%E2%80%9322.pdf)`\n- Feedback from stakeholders also included\nrecommendations for undertaking the evaluation IHPA will continue to refine the methodology for\nprocess: the evaluation of the implemented safety and\nquality reforms, based on the feedback from\n- target specific outcomes, such as the stakeholders, in consultation with jurisdictions\nnumber, proportion and likelihood of and clinical experts.\nsentinel events, hospital acquired\ncomplications and avoidable hospital\nreadmissions in hospitals pre- and\npost-intervention\nIHPA Pricing Framework for Australian Public Hospital Services 2022–23 – Consultation Report 33\n Source: `strategies/pricing_framework_for_australian_public_hospital_services_2022-23_-_consultation.pdf (https://www.ihacpa.gov.au/sites/default/files/2022-08/pricing_framework_for_australian_public_hospital_services_2022-23_-_consultation_report.pdf)`\n\n## Key Issues, Risks, and Recommendations\n\n- [pages 14,15,16,17]\ntal health care national best\nVersion 1.0, and that these risks were also noted in\nendeavours data set Technical Specifications\nthe development of NEP23, namely the:\n2023–24 for Reporting to reflect the complexity\nof different support teams involved in community • potential for a significant funding impact due to\nmental health care. the transition from block funding to ABF\n• price weights are assigned to unknown end • funding implications arising from issues with\nclasses phase level reporting and data collection.\n• provision of phase of care, activity and cost data\nwith error flags to jurisdictions and ensure phase\nof care reflects the services provided and\nresources required to provide services\nIHACPA Pricing Framework for Australian Public Hospital Services 2024–25 Consultation Report 14\n Source: `strategies/IHACPA-pricing-framework-australian-public-hospital-services-2024-25-consultatio.pdf (https://www.ihacpa.gov.au/sites/default/files/2023-12/IHACPA-pricing-framework-australian-public-hospital-services-2024-25-consultation-report.PDF)`\n- As part of the Update to the National Efficient Cost\nWhile ABF will continue to be the best pricing and\nSupplementary Determination 2022–23, IHACPA\nfunding mechanism for many hospital services, the\nincluded block-funded expenditure amounts for a\nAddendum to the National Health Reform\nnumber of innovative models of care proposed by\nAgreement 2020–25 (the Addendum) stipulates\nNew South Wales (NSW), based on a pending\nthat the Independent Health and Aged Care Pricing\ninterim agreement with the Commonwealth to trial\nAuthority (IHACPA) will support the exploration and\nthese models under clause A97 of the Addendum.\ntrial of new and innovative approaches to public\nhospital funding through:\nIHACPA is considering whether refinements to\nexisting classifications or pricing models are\n• developing a funding methodology that\nrequired to support the translation of these\n Source: `strategies/IHACPA-pricing-framework-australian-public-hospital-services-2024-25_1.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-01/IHACPA-pricing-framework-australian-public-hospital-services-2024-25_1.pdf)`\n- [pages 8,9,10,11]\nof Impact\nmust be timely in relation to the matter\nNote: Unless otherwise stated, all references to raised and:\n‘the Addendum’ in this Pricing Framework refer to\nthe Addendum to the National Health Reform • include a risk assessment of the\nAgreement 2020–25. proposed changes or adjustments\n• outline appropriate transition\narrangements\n• be informed by consultation with\nthe parties\n• have input from the Administrator of\nthe National Health Funding Pool.\n Source: `strategies/Pricing-20Framework-20for-20Australian-20Public-20Hospital-20Services-202021-E2-.pdf (https://www.ihacpa.gov.au/sites/default/files/2022-02/Pricing%20Framework%20for%20Australian%20Public%20Hospital%20Services%202021%E2%80%9322.pdf)`\n- [Page 46]\nTable 3: Risk factors for each readmission category\nReadmission category\nIHPA Pricing Framework for Australian Public Hospital Services 2021–22 43\nyrujni\nerusserP\n.1\nsnoitcefni\n.2\nsnoitacilpmoc\nlacigruS\n.3\nsnoitacilpmoc\nyrotaripseR\n.4\nmsilobmeobmorht\nsuoneV\n.5\neruliaf\nlaneR\n.6\ngnideelb\nlanitsetniortsaG\n.7\nsnoitacilpmoc\nlacideM\n.8\nmuirileD\n.9\nsnoitacilpmoc\ncaidraC\n.01\nnoitapitsnoC\n.11\ngnitimov\ndna\naesuaN\n.21\nAge group\n✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓\nMajor diagnostic category (MDC)\n✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓\nEmergency admission flag\n✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓\nDiagnosis-related group (DRG)\ntype ✓ ✓ ✓ ✓ ✓ ✓\nGender\n✓ ✓ ✓ ✓\nTransfer status\n✓\nPatient remoteness\n✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓\nIndigenous status\n✓ ✓ ✓\nObesity\n✓\nHospital Acquired Complication\nflag ✓\nICU hours flag\n✓\nMalnutrition\n✓\nShort stay outlier flag\n✓ ✓ ✓\nNumber of procedures in the index\nepisode ✓ ✓ ✓ ✓\nNumber of admissions in the past\nyear ✓ ✓\n Source: `strategies/Pricing-20Framework-20for-20Australian-20Public-20Hospital-20Services-202021-E2-.pdf (https://www.ihacpa.gov.au/sites/default/files/2022-02/Pricing%20Framework%20for%20Australian%20Public%20Hospital%20Services%202021%E2%80%9322.pdf)`\n- [Page 30]\nFeedback received\nStakeholders suggested the following measures to support the second year of transitioning community mental\nhealth care services to ABF under NEP26:\n• maintain or expand block funding arrangements for specialised or low-volume services that are not\nfinancially sustainable under ABF, to ensure continuity of care and equitable access\n• continue the composite ABF and block funding model in 2026–27 to support funding stability\n• undertake a national review of activity data quality and consistency across states and territories to\nassess readiness for further transition and to avoid premature implementation\n• consider systemic challenges in applying ABF to mental health services, including risks of\nunderfunding, workforce shortages, increasing complexity of patient presentations, and care episodes\ninvolving children or adolescents without the client present\n Source: `strategies/pricing_framework_for_australian_public_hospital_services-consultation_report_1.pdf (https://www.ihacpa.gov.au/sites/default/files/2025-12/pricing_framework_for_australian_public_hospital_services-consultation_report_1.pdf)`\n- Due to the ongoing impact of\nCoronavirus Disease 2019 (COVID-19),\nIHPA will defer investigation of the\nNext steps and future work\nproposed areas and adjustments for\nNEP22 to focus on refinements to the IHPA will consider price harmonisation\npricing model to account for COVID-19. for haemodialysis and chemotherapy\nfor the NEP Determination 2023–24\n(NEP23), noting the need for further\nanalysis on the stability of the\nunderlying data, the suitability of these\nNext steps and future work\nservices for harmonisation and the risk\nIHPA will work with jurisdictions and of potential unintended consequences.\nbroader stakeholders to consider the\nIHPA will also assess the stakeholder\nfeasibility of exploring the above areas\nproposed harmonisations in the\nfor future determinations, pending\ndevelopment of NEP23.\njurisdictional capacity and capability.\n Source: `strategies/pricing_framework_for_australian_public_hospital_services_2022-23.pdf (https://www.ihacpa.gov.au/sites/default/files/2022-08/pricing_framework_for_australian_public_hospital_services_2022-23.pdf)`\n- [pages 32,33,34,35]\ntransitioning to ABF may not reflect the\nacute streams and shadowing to compare ABF\ntrue cost of care, particularly for patients\nallocations with actual costs.\nwith complex conditions and facilities\ntreating very long stay patients\n- risks associated with a new classification\nwhere phase of care is still being refined\n- potential under-pricing leading to\nexacerbation of existing resource issues.\n Source: `strategies/pricing_framework_for_australian_public_hospital_services_2022-23_-_consultation.pdf (https://www.ihacpa.gov.au/sites/default/files/2022-08/pricing_framework_for_australian_public_hospital_services_2022-23_-_consultation_report.pdf)`\n- An exemption mitigates the\nand territories in 2021–22 and the challenges this risk of systematic under or over pricing of specific\npresents for a national pricing model.\n Source: `strategies/IHACPA-pricing-framework-australian-public-hospital-services-2024-25-consultatio.pdf (https://www.ihacpa.gov.au/sites/default/files/2023-12/IHACPA-pricing-framework-australian-public-hospital-services-2024-25-consultation-report.PDF)`\n- [pages 17,18]\nhe\nprevention and control\nrisk of systematic under or over pricing of specific\n• workforce-related capacity constraints and public hospital services year on year, which are the\ncosts and inflationary pressures. result of significant changes to clinical care and\nservice delivery.\n Source: `strategies/IHACPA-pricing-framework-australian-public-hospital-services-2024-25_1.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-01/IHACPA-pricing-framework-australian-public-hospital-services-2024-25_1.pdf)`\n- Committees\nClinical Advisory Committee\nJurisdictional Advisory Committee\nStakeholder Advisory Committee\nAged Care Advisory Committee\nActivity Based Funding Technical Advisory Committee\nNational Hospital Cost Data Collection (NHCDC) Advisory Committee\nAudit Risk and Compliance Committee\nWorkplace Health & Safety Committee\nWorking groups\nClassifications Clinical Advisory Group\nInternational Classification of Diseases (ICD) Technical Group\nDiagnosis Related Groups (DRG) Technical Group\nTeaching, Training and Research Working Group\nSmall Rural Hospitals Working Group\nNon-admitted Care Advisory Working Group\nSubacute Care Working Group\nMental Health Working Group\nEmergency Care Advisory Working Group\nPrivate Sector National Hospital Cost Data Collection Working Group\nPrevious\nWhat we do\nNext\nDiagnosis Related Groups Technical Group\nLast updated:\n14 January 2025\n Source: `pages/taskforces-index.html (https://www.ihacpa.gov.au/about-ihacpa/what-we-do/committees-and-working-groups)`\n- [Page 35]\nPhysical Security\nStaff have annual security training\nPhysical security of staff,\nSecurity checks undertaken\nvisitors or contractors and\nasset security Use of asset registers\nSecurity risk register in place\n3.5 Performance measures\nSection 16EA of the Public Governance, Performance and Accountability Rule 2014 (the PGPA Rule) stipulates\nthe requirements around performance measures for Australian Government entities.\n Source: `corporate-plans/2024-25.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf)`\n- [pages 45,46,47,48]\nbased on the most\nstatistically significant and best performing\nrisk factors.\n Source: `strategies/Pricing-20Framework-20for-20Australian-20Public-20Hospital-20Services-202021-E2-.pdf (https://www.ihacpa.gov.au/sites/default/files/2022-02/Pricing%20Framework%20for%20Australian%20Public%20Hospital%20Services%202021%E2%80%9322.pdf)`\n- Stakeholders were supportive of this approach\nand provided recommendations including:\n– use of 2018–19 data where the 2019–20 Next steps and future work\ndata is not robust\nIHPA will continue to work with\n– undertaking separate analysis for activity jurisdictions to understand the ongoing\nbased funding and block-funded facilities impact of COVID-19 on service delivery,\nactivity levels and models of care, noting\n– consideration of a state and territory level\nthat any changes to the national pricing\nCOVID-19 adjustment\nmodel for future determinations will\nrequire accurate cost and activity data.\n– consideration of a separate COVID-19\nback-casting multiplier\nIHPA will monitor and assess the longer\nterm impacts of COVID-19 as updated\n– sourcing additional data from surgery\ndata becomes available.\nwaitlists and other current records.\n Source: `strategies/pricing_framework_for_australian_public_hospital_services_2022-23.pdf (https://www.ihacpa.gov.au/sites/default/files/2022-08/pricing_framework_for_australian_public_hospital_services_2022-23.pdf)`\n- [Page 20]\n6 Setting the national\nefficient price\nFor the National Efficient Price (NEP) Determination - at present, patient transport is not feasible\n2022–23 (NEP22), the Independent Hospital Pricing for activity based funding due to the lack\nAuthority (IHPA) has deferred consideration of of resource homogeneity.\nproposed refinements to the national pricing model\nStakeholders also provided recommendations for\noutlined in the Consultation Paper, in order to\nsupporting the progression of this work:\nprioritise refinements to the national pricing model\nto adequately account for Coronavirus Disease\n- review the existing patient residential and\n2019 (COVID-19).\n Source: `strategies/pricing_framework_for_australian_public_hospital_services_2022-23_-_consultation.pdf (https://www.ihacpa.gov.au/sites/default/files/2022-08/pricing_framework_for_australian_public_hospital_services_2022-23_-_consultation_report.pdf)`\n\n## Corporate Values and Operating Culture\n\n- [pages 15,16,17,18,19]\nospital\nservices wherever practicable and\ncompatible with delivering value in\nboth outcomes and cost.’\nIHPA has updated the Pricing Guidelines\nPatient-based incorporating stakeholder\nfeedback as follows:\n– Patient-based: ‘Adjustments to the\nstandard price should be, as far as is\npracticable, based on patient-related\nrather than provider-related\ncharacteristics wherever practicable.’\nIHPA has updated the Pricing Guideline\nPublic-private neutrality to reflect the proposed\nwording in the Consultation Paper as follows:\n– Public-private neutrality: ‘ABF pricing\nshould ensure that payments a local\nhospital network (LHN) receives for a\npublic patient should be equal to\npayments made for a LHN service\nfor a private patient.’\nIHPA Pricing Framework for Australian Public Hospital Services 2021–22 12\n Source: `strategies/Pricing-20Framework-20for-20Australian-20Public-20Hospital-20Services-202021-E2-.pdf (https://www.ihacpa.gov.au/sites/default/files/2022-02/Pricing%20Framework%20for%20Australian%20Public%20Hospital%20Services%202021%E2%80%9322.pdf)`\n- As announced in\nthe Federal Budget May 2023–24, the Support at Home Program will be implemented from 1 July 2025.\nj) Aged care accommodation pricing functions under the Aged Care Act 1997\nDeliverable Timeframe\nAssess applications for increases to extra service fees under section 35-1(2) Ongoing\nof the Aged Care Act 1997\nAssess applications for refundable accommodation deposit amounts above Ongoing\nthe Australian Government Minister for Health and Aged Care’s maximum\nunder section 52G-4(5) of the Aged Care Act 1997.\n Source: `corporate-plans/2024-25.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf)`\n- Stakeholders noted the following cost pressures for\nregional or remote hospitals for consideration in 7.2 Standalone\nthe development of the National Efficient Cost\nhospitals providing\n(NEC) Determination 2023–24 (NEC23):\nspecialist mental\n• rural-specific contracts and enterprise\nagreements health services\n• costs associated with rural workforce\nshortages, including locum and contract staff,\nrecruitment and retention costs, absences\nConsultation question\ndue to coronavirus disease 2019 (COVID-19),\nfly-in fly-out arrangements and\naccommodation • What should IHACPA consider when\ntransitioning standalone hospitals\n• regional and remote specific costs, including\nproviding specialist mental health\npatient transport costs, cost of living and\nservices to ABF?\nhigh cost of specialised services and\nmedications due to limited access\n• lack of access to primary care and higher Feedback received\n Source: `strategies/Pricing-20Framework-20for-20Australian-20Public-20Hospital-20Services-202023-24-.pdf (https://www.ihacpa.gov.au/sites/default/files/2022-12/Pricing%20Framework%20for%20Australian%20Public%20Hospital%20Services%202023-24%20-%20Consultation%20Report%20-%20Final.PDF)`\n- IHACPA also public hospital services year on year, which are the\nnotes that costs associated with the health workforce result of significant changes to clinical care and\nare accounted for at a national level through service delivery.\nreporting in the National Hospital Cost Data\nCollection (NHCDC) and thus, cost impacts of To account for the impact of COVID-19 on the\nchanges to the workforce will be accounted for national pricing model for NEP24, IHACPA intends\nwhere reported in national data collections. to:\nIn consultation with jurisdictions, IHACPA has • modify admitted acute activity and cost data\nundertaken detailed analysis to understand and nationally in 2021–22\naccount for the impact of COVID-19 on 2021–22\n• exempt specific end-classes from the National\nactivity and cost data, including significant\nPricing Model Stability Policy.\n Source: `strategies/IHACPA-pricing-framework-australian-public-hospital-services-2024-25-consultatio.pdf (https://www.ihacpa.gov.au/sites/default/files/2023-12/IHACPA-pricing-framework-australian-public-hospital-services-2024-25-consultation-report.PDF)`\n- [Page 5]\nAbbreviations and acronyms\nABF Activity based funding\nACHI Australian Classification of Health Interventions\nACS Australian Coding Standards\nAECC Australian Emergency Care Classification\nAHPCS Australian Hospital Patient Costing Standards\nAMHCC Australian Mental Health Care Classification\nAN-ACC Australian National Aged Care Classification\nAN-SNAP Australian National Subacute and Non-Acute Patient Classification\nAR-DRG Australian Refined Diagnosis Related Groups Classification\nATTC Australian Teaching and Training Classification\nCEO Chief Executive Officer\nCOVID-19 Coronavirus disease 2019\nHAC Hospital acquired complication\nHoNOS Health of the Nation Outcome Scales\nICD‑10‑AM International Statistical Classification of Diseases and Related Health Problems,\nTenth Revision, Australian Modification\nIHACPA Independent Health and Aged Care Pricing Authority\n Source: `corporate-plans/2024-25.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf)`\n- [pages 5,6]\nes Advisory Committee\nNBP National Benchmarking Portal\nNEC National efficient cost\nNEP National efficient price\nNHCDC National Hospital Cost Data Collection\nNHRA National Health Reform Agreement\nNWAU National weighted activity unit\nSDMS Secure Data Management System\nThe addendum Addendum to the National Health Reform Agreement 2020–25\nThe Administrator Administrator of the National Health Funding Pool\nThe Aged Care Act Aged Care Act 1997\nThe Commission Australian Commission on Safety and Quality in Health Care\nThe NHR Act National Health Reform Act 2011\nThe PGPA Act Public Governance, Performance and Accountability Act 2013\nThe PGPA Rule Public Governance, Performance and Accountability Rule 2014\nThe Pricing Authority Governing body of the Independent Health and Aged Care Pricing Authority\n Source: `corporate-plans/2024-25.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf)`\n- The Chief Executive Officer of IHACPA is the accountable authority presenting the IHACPA Work Program and\nCorporate Plan 2024–25, as required under section 225 of the NHR Act and section 35(1)(b) of the Public\nGovernance, Performance and Accountability Act 2013 (the PGPA Act).\n Source: `corporate-plans/2024-25.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf)`\n- [Page 35]\nPhysical Security\nStaff have annual security training\nPhysical security of staff,\nSecurity checks undertaken\nvisitors or contractors and\nasset security Use of asset registers\nSecurity risk register in place\n3.5 Performance measures\nSection 16EA of the Public Governance, Performance and Accountability Rule 2014 (the PGPA Rule) stipulates\nthe requirements around performance measures for Australian Government entities.\n Source: `corporate-plans/2024-25.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf)`\n\n## Global Ideas and Case Study Inputs\n\n_No global-intelligence source text found yet. Run `CLAUDE/global-ideas-scraper.py ` to populate case-study sources._\n\n## Source Artifacts Used\n\n- `corporate-plans/2024-25.pdf` - corporate-plans - https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf\n- `strategies/Pricing-20Framework-20for-20Australian-20Public-20Hospital-20Services-202021-E2-.pdf` - strategies - https://www.ihacpa.gov.au/sites/default/files/2022-02/Pricing%20Framework%20for%20Australian%20Public%20Hospital%20Services%202021%E2%80%9322.pdf\n- `strategies/pricing_framework_for_australian_public_hospital_services_2022-23.pdf` - strategies - https://www.ihacpa.gov.au/sites/default/files/2022-08/pricing_framework_for_australian_public_hospital_services_2022-23.pdf\n- `strategies/pricing_framework_for_australian_public_hospital_services_2022-23_-_consultation.pdf` - strategies - https://www.ihacpa.gov.au/sites/default/files/2022-08/pricing_framework_for_australian_public_hospital_services_2022-23_-_consultation_report.pdf\n- `strategies/Pricing-20Framework-20for-20Australian-20Public-20Hospital-20Services-202023-24-.pdf` - strategies - https://www.ihacpa.gov.au/sites/default/files/2022-12/Pricing%20Framework%20for%20Australian%20Public%20Hospital%20Services%202023-24%20-%20Consultation%20Report%20-%20Final.PDF\n- `strategies/pricing_framework_for_australian_public_hospital_services_2023-24_-_final.pdf` - strategies - https://www.ihacpa.gov.au/sites/default/files/2022-12/pricing_framework_for_australian_public_hospital_services_2023-24_-_final.pdf\n- `strategies/IHACPA-pricing-framework-australian-public-hospital-services-2024-25-consultatio.pdf` - strategies - https://www.ihacpa.gov.au/sites/default/files/2023-12/IHACPA-pricing-framework-australian-public-hospital-services-2024-25-consultation-report.PDF\n- `strategies/IHACPA-pricing-framework-australian-public-hospital-services-2024-25_1.pdf` - strategies - https://www.ihacpa.gov.au/sites/default/files/2024-01/IHACPA-pricing-framework-australian-public-hospital-services-2024-25_1.pdf\n- `strategies/data_request_form_version_8.0.pdf` - strategies - https://www.ihacpa.gov.au/sites/default/files/2025-09/data_request_form_version_8.0.pdf\n- `strategies/pricing_framework_for_australian_public_hospital_services_2025-26-consultation_r.pdf` - strategies - https://www.ihacpa.gov.au/sites/default/files/2024-12/pricing_framework_for_australian_public_hospital_services_2025-26-consultation_report.pdf\n- `strategies/pricing_framework_for_australian_public_hospital_services_2025-26.pdf` - strategies - https://www.ihacpa.gov.au/sites/default/files/2024-12/pricing_framework_for_australian_public_hospital_services_2025-26.pdf\n- `strategies/Pricing_Framework_for_Australian_Public_Hospital_Services_2026-2027_2.pdf` - strategies - https://www.ihacpa.gov.au/sites/default/files/2026-01/Pricing_Framework_for_Australian_Public_Hospital_Services_2026-2027_2.PDF\n- `strategies/pricing_framework_for_australian_public_hospital_services-consultation_report_1.pdf` - strategies - https://www.ihacpa.gov.au/sites/default/files/2025-12/pricing_framework_for_australian_public_hospital_services-consultation_report_1.pdf\n- `pages/about.html` - pages - https://www.ihacpa.gov.au/aged-care/refundable-accommodation-deposits/about\n- `pages/annual-reports-index.html` - pages - https://www.ihacpa.gov.au/sites/default/files/2025-11/ihacpa_annual_report_2024-25_0.pdf\n- `pages/corporate-plans-index.html` - pages - https://www.ihacpa.gov.au/resources/ihacpa-work-program-and-corporate-plan-2024-25\n- `pages/corporate-plans-index__00.html` - pages - https://www.ihacpa.gov.au/resources/ihacpa-work-program-and-corporate-plan-2024-25\n- `pages/corporate-plans-index__01.html` - pages - https://www.ihacpa.gov.au/sites/default/files/2024-06/work_program_and_corporate_plan_2024-25_cover_image.png\n- `pages/corporate-plans-index__02.html` - pages - https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf\n- `pages/corporate-plans-index__03.html` - pages - https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.docx\n- `pages/homepage.html` - pages - https://www.ihacpa.gov.au/\n- `pages/leadership.html` - pages - https://www.ihacpa.gov.au/about-ihacpa/who-we-are/our-people\n- `pages/media-releases-index.html` - pages - https://www.ihacpa.gov.au/health-care/data/data-access-and-release-researchers\n- `pages/news-latest.html` - pages - https://www.ihacpa.gov.au/news-and-events\n- `pages/priorities-index.html` - pages - https://www.ihacpa.gov.au/what-we-do/consultations\n- `pages/reforms-index.html` - pages - https://www.ihacpa.gov.au/resources/fresh-new-approach-ndis-pricing\n- `pages/strategies-index.html` - pages - https://www.ihacpa.gov.au/health-care/pricing/pricing-framework-australian-public-hospital-services\n- `pages/strategies-index__04.html` - pages - https://www.ihacpa.gov.au/health-care/pricing/pricing-framework-australian-public-hospital-services\n- `pages/strategies-index__05.html` - pages - https://www.ihacpa.gov.au/health-care/costing/national-hospital-cost-data-collection\n- `pages/strategies-index__06.html` - pages - https://www.ihacpa.gov.au/health-care/data\n- `pages/strategies-index__07.html` - pages - https://www.ihacpa.gov.au/health-care/data/data-collection\n- `pages/strategies-index__08.html` - pages - https://www.ihacpa.gov.au/health-care/data/data-submission-portal\n- `pages/strategies-index__09.html` - pages - https://www.ihacpa.gov.au/health-care/data/data-access-and-release-researchers\n- `pages/strategies-index__10.html` - pages - https://www.ihacpa.gov.au/health-care/data/data-specifications\n- `pages/strategies-index__11.html` - pages - https://www.ihacpa.gov.au/health-care/data/national-benchmarking-portal\n- `pages/strategies-index__12.html` - pages - https://www.ihacpa.gov.au/aged-care/residential/pricing-framework\n- `pages/strategies-index__13.html` - pages - https://www.ihacpa.gov.au/aged-care/support-at-home/pricing-framework\n- `pages/strategies-index__14.html` - pages - https://www.ihacpa.gov.au/resources/pricing-framework-australian-public-hospital-services-2026-27\n- `pages/strategies-index__15.html` - pages - https://www.ihacpa.gov.au/resources/pricing-framework-australian-public-hospital-services-2025-26\n- `pages/strategies-index__16.html` - pages - https://www.ihacpa.gov.au/resources/pricing-framework-australian-public-hospital-services-2024-25\n- `pages/strategies-index__17.html` - pages - https://www.ihacpa.gov.au/resources/pricing-framework-australian-public-hospital-services-2023-24\n- `pages/strategies-index__18.html` - pages - https://www.ihacpa.gov.au/resources/pricing-framework-australian-public-hospital-services-2022-23\n- `pages/strategies-index__19.html` - pages - https://www.ihacpa.gov.au/resources/pricing-framework-australian-public-hospital-services-2021-22\n- `pages/strategies-index__20.html` - pages - https://www.ihacpa.gov.au/resources/pricing-framework-australian-public-hospital-services-2020-21\n- `pages/strategies-index__21.html` - pages - https://www.ihacpa.gov.au/resources/pricing-framework-australian-public-hospital-services-2019-20\n- `pages/strategies-index__22.html` - pages - https://www.ihacpa.gov.au/resources/pricing-framework-australian-public-hospital-services-2018-19\n- `pages/strategies-index__23.html` - pages - https://www.ihacpa.gov.au/resources/pricing-framework-australian-public-hospital-services-2017-18\n- `pages/strategies-index__24.html` - pages - https://www.ihacpa.gov.au/resources/pricing-framework-australian-public-hospital-services-2016-17\n- `pages/strategies-index__25.html` - pages - https://www.ihacpa.gov.au/resources/pricing-framework-australian-public-hospital-services-2015-16\n- `pages/strategies-index__26.html` - pages - https://www.ihacpa.gov.au/resources/pricing-framework-australian-public-hospital-services-2014-15\n- `pages/strategies-index__27.html` - pages - https://www.ihacpa.gov.au/resources/pricing-framework-australian-public-hospital-services-2013-14\n- `pages/strategies-index__28.html` - pages - https://www.ihacpa.gov.au/resources/pricing-framework-australian-public-hospital-services-2012-13\n- `pages/strategies-index__29.html` - pages - https://www.ihacpa.gov.au/resources/towards-pricing-framework-summary-report\n- `pages/structure.html` - pages - https://www.ihacpa.gov.au/about-ihacpa/who-we-are/organisational-structure\n- `pages/taskforces-index.html` - pages - https://www.ihacpa.gov.au/about-ihacpa/what-we-do/committees-and-working-groups\n- `other-pdfs/Easy-20Read-20A-20Fresh-20Approach-20to-20NDIS-20Pricing.pdf` - other-pdfs - https://engage.ihacpa.gov.au/ndis-pricing/online-submission/supporting_documents/Easy%20Read%20A%20Fresh%20Approach%20to%20NDIS%20Pricing.pdf\n\n## Gaps To Fix\n\n- No annual report text source found.\n- No global comparison/case-study sources found.", "legislation_md": "# Independent Health and Aged Care Pricing Authority Clinical Advisory Committee - Acts and Legislation Discovery\n\n**Generated at**: 2026-05-09T21:12:19.860802+00:00\n**Entity ID**: B-004115\n**Jurisdiction**: Commonwealth\n**Portfolio**: Health, Disability and Ageing\n\n> This is an evidence-based discovery list from scraped department material. A mention does not always mean the department administers the legislation; high-confidence and official register links should be reviewed.\n\n## Summary\n\n- Source files scanned: 57\n- Unique legislation references found: 57\n\n| Type | Count |\n|---|---:|\n| Act | 16 |\n| Determination | 40 |\n| Rules | 1 |\n\n## Legislation References\n\n### National Health Reform Act 2011\n\n**Type**: Act\n**Confidence**: high\n**Mentions**: 27\n**Register search**: https://www.legislation.gov.au/search?query=National+Health+Reform+Act+2011\n\n**Sources**:\n- `pages/corporate-plans-index.html`\n- `pages/corporate-plans-index__00.html`\n- `pages/media-releases-index.html`\n- `pages/strategies-index__09.html`\n- `pages/structure.html`\n- `corporate-plans/2024-25.pages.jsonl`\n- `strategies/data_request_form_version_8.0.pages.jsonl`\n- `strategies/IHACPA-pricing-framework-australian-public-hospital-services-2024-25-consultatio.pages.jsonl`\n- `strategies/IHACPA-pricing-framework-australian-public-hospital-services-2024-25_1.pages.jsonl`\n- `strategies/pricing_framework_for_australian_public_hospital_services-consultation_report_1.pages.jsonl`\n\n**Evidence contexts**:\n- ail\nIHACPA Work Program and Corporate Plan 2024–25\nDate published:\n18 June 2024\nThe Independent Health and Aged Care Pricing Authority (IHACPA) Work Program and Corporate Plan 2024–25 has been prepared in accordance with the requirements of section 225 of the\nNational Health Reform Act 2011\nand section 35(1)(b) of the\nPublic Governance, Performance and Accountability Act 2013\nfor the reporting periods 2024–25 to 2027–28.\nResource type:\nPublications\nIndustry:\nAged care\nHealth care\nTopics:\nPolicy\nDocuments\nDownload\nIHACPA Work Program and Corporat\n Source: `pages/corporate-plans-index.html`\n- ail\nIHACPA Work Program and Corporate Plan 2024–25\nDate published:\n18 June 2024\nThe Independent Health and Aged Care Pricing Authority (IHACPA) Work Program and Corporate Plan 2024–25 has been prepared in accordance with the requirements of section 225 of the\nNational Health Reform Act 2011\nand section 35(1)(b) of the\nPublic Governance, Performance and Accountability Act 2013\nfor the reporting periods 2024–25 to 2027–28.\nResource type:\nPublications\nIndustry:\nAged care\nHealth care\nTopics:\nPolicy\nDocuments\nDownload\nIHACPA Work Program and Corporat\n Source: `pages/corporate-plans-index__00.html`\n- the conduct of research and analysis and to inform the development of policies for improving health outcomes for all Australians.\nIHACPA’s\nData Access and Release Policy\noutlines the principles and process in the access and release of data collected under the\nNational Health Reform Act 2011\n(the Act).\nUnder Section 221 of the Act, IHACPA can release protected Pricing Authority data if it is satisfied the release will assist an agency, body or person to conduct research.\nPlease note data access and release is not related to IHACPA’s obligations u\n Source: `pages/media-releases-index.html`\n- the conduct of research and analysis and to inform the development of policies for improving health outcomes for all Australians.\nIHACPA’s\nData Access and Release Policy\noutlines the principles and process in the access and release of data collected under the\nNational Health Reform Act 2011\n(the Act).\nUnder Section 221 of the Act, IHACPA can release protected Pricing Authority data if it is satisfied the release will assist an agency, body or person to conduct research.\nPlease note data access and release is not related to IHACPA’s obligations u\n Source: `pages/strategies-index__09.html`\n- is page via email\nOrganisational structure\nThe Independent Health and Aged Care Pricing Authority (IHACPA) is a Corporate Commonwealth Entity under the\nPublic Governance, Performance and Accountability\nAct 2013\n.\nIHACPA’s role and functions are set out in the\nNational Health Reform\nAct 2011\nand the\nAged Care\nAct 2024\n.\ndetermination of the national efficient price and national efficient cost for public hospital services\ndevelopment of national classifications for activity based funding\nresolution of disputes on cost-shifting and cross-border iss\n Source: `pages/structure.html`\n\n### Public Governance, Performance and Accountability Act 2013\n\n**Type**: Act\n**Confidence**: high\n**Mentions**: 5\n**Register search**: https://www.legislation.gov.au/search?query=Public+Governance%2C+Performance+and+Accountability+Act+2013\n\n**Sources**:\n- `pages/corporate-plans-index.html`\n- `pages/corporate-plans-index__00.html`\n- `pages/structure.html`\n- `corporate-plans/2024-25.pages.jsonl`\n\n**Evidence contexts**:\n- ished:\n18 June 2024\nThe Independent Health and Aged Care Pricing Authority (IHACPA) Work Program and Corporate Plan 2024–25 has been prepared in accordance with the requirements of section 225 of the\nNational Health Reform Act 2011\nand section 35(1)(b) of the\nPublic Governance, Performance and Accountability Act 2013\nfor the reporting periods 2024–25 to 2027–28.\nResource type:\nPublications\nIndustry:\nAged care\nHealth care\nTopics:\nPolicy\nDocuments\nDownload\nIHACPA Work Program and Corporate Plan 2024-25\npdf\n891.75 KB\nListen to this document\nDownload\nIHACPA Work Program and C\n Source: `pages/corporate-plans-index.html`\n- ished:\n18 June 2024\nThe Independent Health and Aged Care Pricing Authority (IHACPA) Work Program and Corporate Plan 2024–25 has been prepared in accordance with the requirements of section 225 of the\nNational Health Reform Act 2011\nand section 35(1)(b) of the\nPublic Governance, Performance and Accountability Act 2013\nfor the reporting periods 2024–25 to 2027–28.\nResource type:\nPublications\nIndustry:\nAged care\nHealth care\nTopics:\nPolicy\nDocuments\nDownload\nIHACPA Work Program and Corporate Plan 2024-25\npdf\n891.75 KB\nListen to this document\nDownload\nIHACPA Work Program and C\n Source: `pages/corporate-plans-index__00.html`\n- age\nShare\nthis page\nShare this page on Facebook\nShare this page on Twitter\nShare this page LinkedIn\nShare this page via email\nOrganisational structure\nThe Independent Health and Aged Care Pricing Authority (IHACPA) is a Corporate Commonwealth Entity under the\nPublic Governance, Performance and Accountability\nAct 2013\n.\nIHACPA’s role and functions are set out in the\nNational Health Reform\nAct 2011\nand the\nAged Care\nAct 2024\n.\ndetermination of the national efficient price and national efficient cost for public hospital services\ndevelopment of national classifications for ac\n Source: `pages/structure.html`\n- NHR Act) to improve health outcomes for all Australians.\nThe Chief Executive Officer of IHACPA is the accountable authority presenting the IHACPA Work Program and\nCorporate Plan 2024–25, as required under section 225 of the NHR Act and section 35(1)(b) of the Public\nGovernance, Performance and Accountability Act 2013 (the PGPA Act). The NHR Act requires annual reporting\non strategic objectives and key activities developed for IHACPA’s annual Work Program while the PGPA Act\nspecifies reporting on corporate outcomes and performance measures across 2024–25 to 2027–28.\nThe IH\n Source: `corporate-plans/2024-25.pages.jsonl`\n- ACPA has a broad range of compliance obligations, including key statutory obligations set out in the NHR Act,\nthe National Health Reform Agreement, the Aged Care Act 1997, the Aged Care and Other Legislation\nAmendment (Royal Commission Response) Act 2022, the Public Governance Performance and Accountability\nAct 2013, and the Public Governance Performance and Accountability Rule 2014. Other legal and compliance\nobligations include, work health and safety, privacy, freedom of information, intellectual property, the Protective\nSecurity Policy Framework, website accessibilit\n Source: `corporate-plans/2024-25.pages.jsonl`\n\n### Aged Care Act 1997\n\n**Type**: Act\n**Confidence**: high\n**Mentions**: 4\n**Register search**: https://www.legislation.gov.au/search?query=Aged+Care+Act+1997\n\n**Sources**:\n- `corporate-plans/2024-25.pages.jsonl`\n\n**Evidence contexts**:\n- ged care services, for consideration in Australian Government funding\ndecisions\n• reviewing data, conducting studies and undertaking consultation for the purpose of providing aged care\ncosting and pricing advice\n• performing such functions as conferred by the Aged Care Act 1997 (the Aged Care Act) or the Aged Care\n(Transitional Provisions) Act 1997\n• performing other functions relating to aged care (if any) specified in regulations\n• undertaking other actions incidental or conducive to the performance of the above functions.\nIHACPA\n Source: `corporate-plans/2024-25.pages.jsonl`\n- s of pricing advice for the Support at Home\nfunding model.\nAs part of IHACPA’s expanded remit, IHACPA is also responsible for approving higher maximum accommodation\npayment amounts and increases to extra service fees, as part of the functions conferred by the Aged Care Act\n1997.\nAs announced in the Federal Budget May 2024–25, IHACPA will work with the Department of Social Services and\nthe National Disability Insurance Agency to undertake initial work to reform the National Disability Insurance\nScheme pricing arrangements, including\n Source: `corporate-plans/2024-25.pages.jsonl`\n- inform Australian Government policy and funding decisions on the Support at Home Program. As announced in\nthe Federal Budget May 2023–24, the Support at Home Program will be implemented from 1 July 2025.\nj) Aged care accommodation pricing functions under the Aged Care Act 1997\nDeliverable Timeframe\nAssess applications for increases to extra service fees under section 35-1(2) Ongoing\nof the Aged Care Act 1997\nAssess applications for refundable accommodation deposit amounts above Ongoing\nthe Australian Government Minister for Health\n Source: `corporate-plans/2024-25.pages.jsonl`\n- es to extra service fees under section 35-1(2) Ongoing\nof the Aged Care Act 1997\nAssess applications for refundable accommodation deposit amounts above Ongoing\nthe Australian Government Minister for Health and Aged Care’s maximum\nunder section 52G-4(5) of the Aged Care Act 1997.\nAged care accommodation\nIHACPA also has responsibility for the functions previously undertaken by the Aged Care Pricing Commissioner.\nThese include:\n• the approval or rejection of increases to extra service fees; and\n• the approval or refusal of proposed ref\n Source: `corporate-plans/2024-25.pages.jsonl`\n\n### For the NEP Determination 2021\n\n**Type**: Determination\n**Confidence**: high\n**Mentions**: 3\n**Register search**: https://www.legislation.gov.au/search?query=For+the+NEP+Determination+2021\n\n**Sources**:\n- `strategies/Pricing-20Framework-20for-20Australian-20Public-20Hospital-20Services-202021-E2-.pages.jsonl`\n- `strategies/pricing_framework_for_australian_public_hospital_services_2022-23.pages.jsonl`\n\n**Evidence contexts**:\n- nt price for\nactivity based funded\npublic hospitals\nIHPA Pricing Framework for Australian Public Hospital Services 2021–22 22\n\n[page 26]\n7 Setting the national efficient\nprice for activity based\nfunded public hospitals\nUnder clause A7 of the Addendum, IHPA is For the NEP Determination 2021–22 (NEP21),\nrequired to determine the national efficient price IHPA reviewed the need for an adjustment for\n(NEP) for health care services provided by public patient transport in rural areas, including medical\nhospitals where services are funded on an activit\n Source: `strategies/Pricing-20Framework-20for-20Australian-20Public-20Hospital-20Services-202021-E2-.pages.jsonl`\n- classification systems.\nIHPA Pricing Framework for Australian Public Hospital Services 2022–23 12\n\n[page 16]\n5.2.1. AR-DRG Version 11.0 5.2.2. Enhancing education\nand ICD-10-AM/ACHI/ACS materials for admitted acute\nTwelfth Edition care classification systems\nFor the NEP Determination 2021–22 (NEP21), IHPA is exploring options for the development of\nIHPA used AR-DRG Version 10.0 and an interactive and responsive online educational\nICD-10-AM/ACHI/ACS Eleventh Edition to price program for new versions of the admitted acute\nadmitted acute patient\n Source: `strategies/pricing_framework_for_australian_public_hospital_services_2022-23.pages.jsonl`\n- ry\ndata collections or ABF. Their costs are assigned ABF payments, insurer payments and\nto the mother’s record and included in the delivery Medicare Benefit Schedule (MBS) payments).\nDiagnosis Related Group (DRG) price.\nStakeholders noted that the bundling of For the NEP Determination 2021–22 (NEP21)\nunqualified newborns within the maternal DRG IHPA implemented a private patient neutrality\nmay not adequately reflect the cost of care, and methodology whereby the private funding neutrality\nrequested that IHPA review how neonatal ICU adjustment wi\n Source: `strategies/pricing_framework_for_australian_public_hospital_services_2022-23.pages.jsonl`\n\n### For the NEP Determination 2022\n\n**Type**: Determination\n**Confidence**: high\n**Mentions**: 3\n**Register search**: https://www.legislation.gov.au/search?query=For+the+NEP+Determination+2022\n\n**Sources**:\n- `strategies/IHACPA-pricing-framework-australian-public-hospital-services-2024-25-consultatio.pages.jsonl`\n- `strategies/pricing_framework_for_australian_public_hospital_services_2022-23.pages.jsonl`\n- `strategies/pricing_framework_for_australian_public_hospital_services_2023-24_-_final.pages.jsonl`\n\n**Evidence contexts**:\n- ram of work to refine and the development of risk mitigation\nthe national pricing model, based on data driven, strategies to support the transition to\nevidence-based methodologies, in consultation with ABF, are there any significant barriers to\njurisdictions. For the NEP Determination 2022–23 pricing community mental health care\n(NEP22), it was determined that there was sufficient using AMHCC Version 1.0 for NEP24?\nstability and availability of National Hospital Cost\n• Are there any other measures that will\nData Collection (NHCDC) data to suppo\n Source: `strategies/IHACPA-pricing-framework-australian-public-hospital-services-2024-25-consultatio.pages.jsonl`\n- to the National Pricing Model\npricing model is described in further detail in the Framework (the Alterations Framework) and the\nNational Pricing Model Technical Specifications on Shadow Pricing Guidelines to address the\nIHPA’s website. Addendum requirements.\nFor the NEP Determination 2022–23 (NEP22) The Alterations Framework outlines the consultative\nIHPA has deferred consideration of the proposed mechanisms that IHPA follows when implementing\nrefinements to the national pricing model outlined changes that materially impact the application of\n Source: `strategies/pricing_framework_for_australian_public_hospital_services_2022-23.pages.jsonl`\n- aking development of AR-DRG\nICD-10-AM/ACHI/ACS Twelfth Edition was released Version 12.0 and ICD-10-AM/ACHI/ACS\nin March 2022 alongside a comprehensive education Thirteenth Edition, in line with the\nprogram outlining its changes. three-year development cycle.\nFor the NEP Determination 2022–23 (NEP22), IHACPA\nused AR-DRG Version 10.0 and ICD-10-AM/ACHI/ACS\nTwelfth Edition to price admitted acute patient\nservices.\nIHACPA Pricing Framework for Australian Public Hospital Services 2023–24 16\n\n[page 17]\nA majority of jurisdictions requested that IHAC\n Source: `strategies/pricing_framework_for_australian_public_hospital_services_2023-24_-_final.pages.jsonl`\n\n### Since the NEC Determination 2020\n\n**Type**: Determination\n**Confidence**: high\n**Mentions**: 3\n**Register search**: https://www.legislation.gov.au/search?query=Since+the+NEC+Determination+2020\n\n**Sources**:\n- `strategies/IHACPA-pricing-framework-australian-public-hospital-services-2024-25_1.pages.jsonl`\n- `strategies/pricing_framework_for_australian_public_hospital_services_2025-26.pages.jsonl`\n- `strategies/Pricing_Framework_for_Australian_Public_Hospital_Services_2026-2027_2.pages.jsonl`\n\n**Evidence contexts**:\n- m standalone hospitals providing specialist mental\nfunded model calculates an efficient cost for the health services that received block funding in the\nhospital. NEC Determination 2023–24 (NEC23) to identify\nhospitals that exceeded the ‘low-volume’ threshold.\nSince the NEC Determination 2020–21, IHACPA has Based on eligibility criteria used to determine\nused a ‘fixed-plus-variable’ model where the total whether a public hospital is eligible to receive block\nmodelled cost of each hospital is based on a fixed funding, as well as consideration of th\n Source: `strategies/IHACPA-pricing-framework-australian-public-hospital-services-2024-25_1.pages.jsonl`\n- Both ABF and block funding approaches cover services that are within the scope of the NHRA. The key difference is that\nthe ABF model calculates an efficient price per episode of care, while the block funded model calculates an efficient cost\nfor the hospital.\nSince the NEC Determination 2020–21, IHACPA has used a fixed-plus-variable model where the total modelled cost of\neach hospital is based on a fixed component as well as a variable ABF style component. Under this approach, the fixed\ncomponent decreases while the variable component increases,\n Source: `strategies/pricing_framework_for_australian_public_hospital_services_2025-26.pages.jsonl`\n- Both ABF and block funding approaches cover services that are within the scope of the NHRA. The key\ndifference is that the ABF model calculates an efficient price per episode of care, while the block funded\nmodel calculates an efficient cost for the hospital.\nSince the NEC Determination 2020–21, IHACPA has used a ‘fixed-plus-variable’ model where the total\nmodelled cost of eligible hospitals is based on a fixed component as well as a variable ABF-style component.\nUnder this approach, the fixed component decreases as the variable component increas\n Source: `strategies/Pricing_Framework_for_Australian_Public_Hospital_Services_2026-2027_2.pages.jsonl`\n\n### Under the National Health Reform Act 2011\n\n**Type**: Act\n**Confidence**: medium\n**Mentions**: 2\n**Register search**: https://www.legislation.gov.au/search?query=Under+the+National+Health+Reform+Act+2011\n\n**Sources**:\n- `pages/leadership.html`\n- `strategies/Pricing_Framework_for_Australian_Public_Hospital_Services_2026-2027_2.pages.jsonl`\n\n**Evidence contexts**:\n- Our people | IHACPA\n\nBreadcrumb\nListen\nto the content of this page\nPrint\nthe content of this page\nShare\nthis page\nShare this page on Facebook\nShare this page on Twitter\nShare this page LinkedIn\nShare this page via email\nOur people\nUnder the\nNational Health Reform Act 2011\n, the Independent Health and Aged Care Pricing Authority's (IHACPA) Chief Executive Officer (CEO) is a statutory office holder and reports to the Pricing Authority, which reports to the\nMinister for Health and Ageing\n.\nThe CEO is responsible for the effective\n Source: `pages/leadership.html`\n- anism.\nClassifications are also used for purposes other than ABF including health service planning, benchmarking,\nepidemiology and research, funding agreements between private hospitals and insurers and monitoring the\nquality of healthcare and patient safety.\nUnder the National Health Reform Act 2011 and the Addendum to the National Health Reform Agreement\n(NHRA) 2020–26, the Independent Health and Aged Care Pricing Authority (IHACPA) is responsible for\nreviewing and updating existing classifications, as well as introducing new classifications.\nThere are\n Source: `strategies/Pricing_Framework_for_Australian_Public_Hospital_Services_2026-2027_2.pages.jsonl`\n\n### Addendum to the National Health Reform For the NEP Determination 2023\n\n**Type**: Determination\n**Confidence**: medium\n**Mentions**: 1\n**Register search**: https://www.legislation.gov.au/search?query=Addendum+to+the+National+Health+Reform+For+the+NEP+Determination+2023\n\n**Sources**:\n- `strategies/pricing_framework_for_australian_public_hospital_services_2023-24_-_final.pages.jsonl`\n\n**Evidence contexts**:\n- abled.\nIHACPA Pricing Framework for Australian Public Hospital Services 2023–24 20\n\n[page 21]\n6\nSetting the national\nefficient price\nIHACPA Pricing Framework for Australian Public Hospital Services 2023–24 21\n\n[page 22]\n6. Setting the national\nefficient price\nThe Addendum to the National Health Reform For the NEP Determination 2023–24 (NEP23), IHACPA\nAgreement 2020–25 (the Addendum) specifies that has reinvestigated the need for an adjustment for\none of the Independent Health and Aged Care Pricing patient transport in rural and remote areas,\nAuthority’s (IHACPA) determinative functions\n Source: `strategies/pricing_framework_for_australian_public_hospital_services_2023-24_-_final.pages.jsonl`\n\n### Administrator Administrator of the National Health Funding Pool The Aged Care Act Aged Care Act 1997\n\n**Type**: Act\n**Confidence**: medium\n**Mentions**: 1\n**Register search**: https://www.legislation.gov.au/search?query=Administrator+Administrator+of+the+National+Health+Funding+Pool+The+Aged+Care+Act+Aged+Care+Act+1997\n\n**Sources**:\n- `corporate-plans/2024-25.pages.jsonl`\n\n**Evidence contexts**:\n- cost\nNEP National efficient price\nNHCDC National Hospital Cost Data Collection\nNHRA National Health Reform Agreement\nNWAU National weighted activity unit\nSDMS Secure Data Management System\nThe addendum Addendum to the National Health Reform Agreement 2020–25\nThe Administrator Administrator of the National Health Funding Pool\nThe Aged Care Act Aged Care Act 1997\nThe Commission Australian Commission on Safety and Quality in Health Care\nThe NHR Act National Health Reform Act 2011\nThe PGPA Act Public Governance, Performance and Accountability Act 2013\nThe PGPA Rule Public Governance, Performance and Accountability Rule\n Source: `corporate-plans/2024-25.pages.jsonl`\n\n### Commission Australian Commission on Safety and Quality in Health Care The NHR Act National Health Reform Act 2011\n\n**Type**: Act\n**Confidence**: medium\n**Mentions**: 1\n**Register search**: https://www.legislation.gov.au/search?query=Commission+Australian+Commission+on+Safety+and+Quality+in+Health+Care+The+NHR+Act+National+Health+Reform+Act+2011\n\n**Sources**:\n- `corporate-plans/2024-25.pages.jsonl`\n\n**Evidence contexts**:\n- rm Agreement\nNWAU National weighted activity unit\nSDMS Secure Data Management System\nThe addendum Addendum to the National Health Reform Agreement 2020–25\nThe Administrator Administrator of the National Health Funding Pool\nThe Aged Care Act Aged Care Act 1997\nThe Commission Australian Commission on Safety and Quality in Health Care\nThe NHR Act National Health Reform Act 2011\nThe PGPA Act Public Governance, Performance and Accountability Act 2013\nThe PGPA Rule Public Governance, Performance and Accountability Rule 2014\nThe Pricing Authority Governing body of the Independent Health and Aged Care Pricing Authority\n\n[page 6]\n1. Intro\n Source: `corporate-plans/2024-25.pages.jsonl`\n\n### Commission Australian Commission on Safety and Quality in Health Care The NHR Act The National Health Reform Act 2011\n\n**Type**: Act\n**Confidence**: medium\n**Mentions**: 1\n**Register search**: https://www.legislation.gov.au/search?query=Commission+Australian+Commission+on+Safety+and+Quality+in+Health+Care+The+NHR+Act+The+National+Health+Reform+Act+2011\n\n**Sources**:\n- `strategies/pricing_framework_for_australian_public_hospital_services-consultation_report_1.pages.jsonl`\n\n**Evidence contexts**:\n- DC National Hospital Cost Data Collection\nNHFB National Health Funding Body\nNHRA National Health Reform Agreement\nNWAU National weighted activity unit\nPBS Pharmaceutical Benefits Scheme\nThe addendum Addendum to the National Health Reform Agreement 2020–26\nThe Commission Australian Commission on Safety and Quality in Health Care\nThe NHR Act The National Health Reform Act 2011\nThe pricing framework The Pricing Framework for Australian Public Hospital Services\n2026–27\nTier 2 Tier 2 Non-Admitted Services Classification\nVAD Voluntary assisted dying\nIHACPA Pricing Framework for Australian Public Hospital Services 2026–27 – Consultation\n Source: `strategies/pricing_framework_for_australian_public_hospital_services-consultation_report_1.pages.jsonl`\n\n### Healthcare Identifiers Act 2010\n\n**Type**: Act\n**Confidence**: medium\n**Mentions**: 1\n**Register search**: https://www.legislation.gov.au/search?query=Healthcare+Identifiers+Act+2010\n\n**Sources**:\n- `strategies/data_request_form_version_8.0.pages.jsonl`\n\n**Evidence contexts**:\n- edition/version where applicable\n• how the variables will be used in any analysis\n• period the data is required for\n• any other information that may support this request.\nNote: IHACPA will not disclose Individual Healthcare Identifier data obtained under the\nHealthcare Identifiers Act 2010 to any requestor.\nData sets and variables requested:\nDesired outputs:\nTime period/s of interest\nStart date: End date:\nIHACPA Data Request Form 4\n\n[page 5]\nIntended use of information\nDetail the research project description including purpose, duration, potenti\n Source: `strategies/data_request_form_version_8.0.pages.jsonl`\n\n### Independent Hospital Pricing Authority (IHPA) and the Australian Commission on Safety For the NEP Determination 2022\n\n**Type**: Determination\n**Confidence**: medium\n**Mentions**: 1\n**Register search**: https://www.legislation.gov.au/search?query=Independent+Hospital+Pricing+Authority+%28IHPA%29+and+the+Australian+Commission+on+Safety+For+the+NEP+Determination+2022\n\n**Sources**:\n- `strategies/pricing_framework_for_australian_public_hospital_services_2022-23.pages.jsonl`\n\n**Evidence contexts**:\n- age 36]\n11\nPricing and funding for\nsafety and quality\nIHPA Pricing Framework for Australian Public Hospital Services 2022–23 33\n\n[page 37]\n11 Pricing and funding for\nsafety and quality\n11.1. Overview\nIHPA’s decision\nThe Independent Hospital Pricing Authority\n(IHPA) and the Australian Commission on Safety\nFor the NEP Determination 2022–23\nand Quality in Health Care (the Commission)\n(NEP22), IHPA will continue to assign\nfollow a collaborative work program to incorporate\nzero NWAU to episodes with a sentinel\nsafety and quality measures into determining the\nevent using Version 2.0 of the Austr\n Source: `strategies/pricing_framework_for_australian_public_hospital_services_2022-23.pages.jsonl`\n\n### NHR Act, the National Health Reform Agreement, the Aged Care Act 1997\n\n**Type**: Act\n**Confidence**: medium\n**Mentions**: 1\n**Register search**: https://www.legislation.gov.au/search?query=NHR+Act%2C+the+National+Health+Reform+Agreement%2C+the+Aged+Care+Act+1997\n\n**Sources**:\n- `corporate-plans/2024-25.pages.jsonl`\n\n**Evidence contexts**:\n- nt deceptive activities, supported by monitoring controls\nto detect fraud and deter offending behaviour, and is reviewed annually or as required.\nCompliance\nIHACPA has a broad range of compliance obligations, including key statutory obligations set out in the NHR Act,\nthe National Health Reform Agreement, the Aged Care Act 1997, the Aged Care and Other Legislation\nAmendment (Royal Commission Response) Act 2022, the Public Governance Performance and Accountability\nAct 2013, and the Public Governance Performance and Accountability Rule 2014. Other legal and compliance\nobligations incl\n Source: `corporate-plans/2024-25.pages.jsonl`\n\n### Private Health Insurance Act 2007\n\n**Type**: Act\n**Confidence**: medium\n**Mentions**: 1\n**Register search**: https://www.legislation.gov.au/search?query=Private+Health+Insurance+Act+2007\n\n**Sources**:\n- `corporate-plans/2024-25.pages.jsonl`\n\n**Evidence contexts**:\n- th insurers are required to pay hospitals that utilise these devices in the provision of care to\nprivately insured individuals. The Prostheses List forms part of the Private Health Insurance (Prostheses)\nRules, which is a legislative instrument made under the Private Health Insurance Act 2007.\nIHACPA Work Program and Corporate Plan 2024–25 14\n\n[page 15]\nIn 2021, the Australian Government Department of Health and Aged Care commenced four years of reform\nactivity to improve the Prostheses List and its arrangements. These reforms include changes aime\n Source: `corporate-plans/2024-25.pages.jsonl`\n\n### Aged Care Act 2024\n\n**Type**: Act\n**Confidence**: low\n**Mentions**: 2\n**Register search**: https://www.legislation.gov.au/search?query=Aged+Care+Act+2024\n\n**Sources**:\n- `pages/structure.html`\n\n**Evidence contexts**:\n- re\nThe Independent Health and Aged Care Pricing Authority (IHACPA) is a Corporate Commonwealth Entity under the\nPublic Governance, Performance and Accountability\nAct 2013\n.\nIHACPA’s role and functions are set out in the\nNational Health Reform\nAct 2011\nand the\nAged Care\nAct 2024\n.\ndetermination of the national efficient price and national efficient cost for public hospital services\ndevelopment of national classifications for activity based funding\nresolution of disputes on cost-shifting and cross-border issues\nprovision of advice on\n Source: `pages/structure.html`\n- mmodation deposits\nabove the maximum prescribed by the\nAged Care\nRules 2025\n. 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\nAged Care\nAct 2024\n.\nCorporate Affairs\nCommunications\nThe 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 communica\n Source: `pages/structure.html`\n\n### Efficient Price Determination 2022\n\n**Type**: Determination\n**Confidence**: low\n**Mentions**: 2\n**Register search**: https://www.legislation.gov.au/search?query=Efficient+Price+Determination+2022\n\n**Sources**:\n- `strategies/IHACPA-pricing-framework-australian-public-hospital-services-2024-25-consultatio.pages.jsonl`\n- `strategies/pricing_framework_for_australian_public_hospital_services_2022-23_-_consultation.pages.jsonl`\n\n**Evidence contexts**:\n- bmit data under the\nemergency care virtual care data IHACPA notes that the mental health co-responder\nspecification\nprogram was included on the General List of In-\nScope Public Hospital Services for the National\nQueensland (Qld) and South Australia (SA) noted\nEfficient Price Determination 2022–23 and that a\nthey have capacity to submit emergency care virtual\nnew class for genetic counselling was included in\ncare data, while New South Wales (NSW) and Tas\nTier 2 Non-Admitted Care Classification Version 8.0\nnoted they did not have the capacity to supp\n Source: `strategies/IHACPA-pricing-framework-australian-public-hospital-services-2024-25-consultatio.pages.jsonl`\n- d to a negative\nimpact on funding. IHPA notes that more time\nmay be required for stabilisation of the AMHCC\nmodel and improvement in data integrity and\ncoverage following progression to pricing of\nadmitted mental health care for the National\nFeedback received\nEfficient Price Determination 2022–23.\nNSW, Vic, Qld, WA, Tas, ACEM and QNMU IHPA will work with jurisdictions to facilitate the\nnoted the following concerns regarding the transition of block-funded standalone hospitals\ntransition of block-funded standalone hospitals providing specialist menta\n Source: `strategies/pricing_framework_for_australian_public_hospital_services_2022-23_-_consultation.pages.jsonl`\n\n### For the NEP Determination 2024\n\n**Type**: Determination\n**Confidence**: low\n**Mentions**: 2\n**Register search**: https://www.legislation.gov.au/search?query=For+the+NEP+Determination+2024\n\n**Sources**:\n- `strategies/IHACPA-pricing-framework-australian-public-hospital-services-2024-25_1.pages.jsonl`\n- `strategies/pricing_framework_for_australian_public_hospital_services_2025-26.pages.jsonl`\n\n**Evidence contexts**:\n- Report.\nAuthority (IHACPA) is responsible for reviewing\nand updating existing classifications, as well as\nintroducing new classifications. IHACPA’s decision\nThere are currently six public hospital service\ncategories in Australia which have classifications in For the NEP Determination 2024–25\n(NEP24), IHACPA will continue to use\nuse or in development:\nAR-DRG Version 11.0 and\n• admitted acute care ICD-10-AM/ACHI/ACS Twelfth Edition to\nprice admitted acute patient services.\n• subacute and non-acute care\n• emergency care\n• non-admitted care\n• ment\n Source: `strategies/IHACPA-pricing-framework-australian-public-hospital-services-2024-25_1.pages.jsonl`\n- blic Hospital Services 2025–26 27\n\n[page 28]\nNext steps and future work\nIHACPA is currently consulting with state and territory governments and its advisory committees and intends\nto complete the Data Quality Framework by July 2025.\n6.2 Assurance of cost data\nFor the NEP Determination 2024–25, IHACPA undertook quality assurance of the 2021–22 NHCDC data submissions and\nNHCDC data quality statements through bilateral meetings with each state and territory. This process involved reviewing\nthe NHCDC submissions to understand how the NHCDC data was\n Source: `strategies/pricing_framework_for_australian_public_hospital_services_2025-26.pages.jsonl`\n\n### For the NEP Determination 2025\n\n**Type**: Determination\n**Confidence**: low\n**Mentions**: 2\n**Register search**: https://www.legislation.gov.au/search?query=For+the+NEP+Determination+2025\n\n**Sources**:\n- `strategies/pricing_framework_for_australian_public_hospital_services_2025-26.pages.jsonl`\n\n**Evidence contexts**:\n- mentation on\n1 July 2025. AR-DRG Version 12.0 will be released in 2025 and used to price admitted acute patient services for the NEP\nDetermination 2026–27.\nIHACPA Pricing Framework for Australian Public Hospital Services 2025–26 9\n\n[page 10]\nIHACPA’s decision\nFor the NEP Determination 2025–26 (NEP25), IHACPA will use ICD-10-AM/ACHI/ACS Thirteenth Edition,\nand continue to use AR-DRG Version 11.0, to price admitted acute patient services.\n3.1.2 Cluster coding\nIHACPA is proposing to implement cluster coding from 1 July 2025 in conjunction with the\n Source: `strategies/pricing_framework_for_australian_public_hospital_services_2025-26.pages.jsonl`\n- nt. The Data Quality Framework will also allow IHACPA to implement a\nuniform approach to quality assurance to assess what would be considered an appropriate and representative sample of\ndata required to deliver IHACPA’s legislated functions.\nIHACPA’s decision\nFor the NEP Determination 2025–26 (NEP25), IHACPA will continue to implement the requirements outlined\nin its Three Year Data Plan and Data Compliance Policy. These require states and territories to provide\nsufficient data, for IHACPA to have confidence that the data reflects the actual co\n Source: `strategies/pricing_framework_for_australian_public_hospital_services_2025-26.pages.jsonl`\n\n### Freedom of Information Act 1982\n\n**Type**: Act\n**Confidence**: low\n**Mentions**: 2\n**Register search**: https://www.legislation.gov.au/search?query=Freedom+of+Information+Act+1982\n\n**Sources**:\n- `pages/media-releases-index.html`\n- `pages/strategies-index__09.html`\n\n**Evidence contexts**:\n- ).\nUnder Section 221 of the Act, IHACPA can release protected Pricing Authority data if it is satisfied the release will assist an agency, body or person to conduct research.\nPlease note data access and release is not related to IHACPA’s obligations under the\nFreedom of Information Act 1982\n(FOI Act). For applications under the FOI Act, see\nIHACPA’s Freedom of Information webpage\n.\nPlease see IHACPA’s FAQs on the data access and release process to assist researchers in preparing an application.\nFrequently asked questions\nWho is considered a rese\n Source: `pages/media-releases-index.html`\n- ).\nUnder Section 221 of the Act, IHACPA can release protected Pricing Authority data if it is satisfied the release will assist an agency, body or person to conduct research.\nPlease note data access and release is not related to IHACPA’s obligations under the\nFreedom of Information Act 1982\n(FOI Act). For applications under the FOI Act, see\nIHACPA’s Freedom of Information webpage\n.\nPlease see IHACPA’s FAQs on the data access and release process to assist researchers in preparing an application.\nFrequently asked questions\nWho is considered a rese\n Source: `pages/strategies-index__09.html`\n\n### NEP26) and NEC Determination 2026\n\n**Type**: Determination\n**Confidence**: low\n**Mentions**: 2\n**Register search**: https://www.legislation.gov.au/search?query=NEP26%29+and+NEC+Determination+2026\n\n**Sources**:\n- `strategies/pricing_framework_for_australian_public_hospital_services-consultation_report_1.pages.jsonl`\n- `strategies/Pricing_Framework_for_Australian_Public_Hospital_Services_2026-2027_2.pages.jsonl`\n\n**Evidence contexts**:\n- onsultation feedback are summarised in this report, corresponding with the chapters in the\npricing framework. This stakeholder feedback has informed the development of the pricing framework,\nincluding the decisions that underpin the NEP Determination 2026–27 (NEP26) and NEC Determination\n2026–27 (NEC26).\nIHACPA has included some of its own general feedback within this report and will respond to stakeholders\ndirectly where specific issues were highlighted relevant to that organisation. IHACPA will consider any\nfeedback provided outside the specific\n Source: `strategies/pricing_framework_for_australian_public_hospital_services-consultation_report_1.pages.jsonl`\n- efers to the addendum and subsequent Schedule K\nextension as the Addendum to the NHRA 2020–26.\nThis pricing framework has been developed within this legislated context and will focus on the issues pertinent\nto the development of the NEP Determination 2026–27 (NEP26) and NEC Determination 2026–27 (NEC26)\nthat are within IHACPA’s current legislated and policy remit. Once agreed, the implications of a new\naddendum for future determinations will be considered in consultation with stakeholders.\nIHACPA Pricing Framework for Australian Public Hospital Se\n Source: `strategies/Pricing_Framework_for_Australian_Public_Hospital_Services_2026-2027_2.pages.jsonl`\n\n### National Efficient Price (NEP) Determination 2025\n\n**Type**: Determination\n**Confidence**: low\n**Mentions**: 2\n**Register search**: https://www.legislation.gov.au/search?query=National+Efficient+Price+%28NEP%29+Determination+2025\n\n**Sources**:\n- `strategies/pricing_framework_for_australian_public_hospital_services_2025-26-consultation_r.pages.jsonl`\n\n**Evidence contexts**:\n- lthcare Australia (CHA), the College of Intensive Care Medicine of Australia and\nNew Zealand (CICM), and the Royal Australasian College of Physicians (RACP) recommended a review of the impact of\nthe COVID-19 pandemic response for the National Efficient Price (NEP) Determination 2025–26 (NEP25). Specifically,\nstakeholders recommended reviewing the following:\n• impact on emergency department presentations and elective surgery admissions\n• influenza cases\n• implications of Long COVID-19\n• public health physician and other non-procedural sub\n Source: `strategies/pricing_framework_for_australian_public_hospital_services_2025-26-consultation_r.pages.jsonl`\n- he\nIHACPA Three Year Data Plan, and a statement of assurance on the completeness and accuracy of approved data\nsubmissions. Nevertheless, IHACPA has provided material to support national consistency in reporting of cost data.\nFor the National Efficient Price (NEP) Determination 2025–26 (NEP25), IHACPA will continue to implement the\nrequirements outlined in the IHACPA Three Year Data Plan and Data Compliance Policy. These require states and\nterritories to provide sufficient data for IHACPA to have confidence that the data reflects the act\n Source: `strategies/pricing_framework_for_australian_public_hospital_services_2025-26-consultation_r.pages.jsonl`\n\n### National Efficient Price Determination 2023\n\n**Type**: Determination\n**Confidence**: low\n**Mentions**: 2\n**Register search**: https://www.legislation.gov.au/search?query=National+Efficient+Price+Determination+2023\n\n**Sources**:\n- `strategies/IHACPA-pricing-framework-australian-public-hospital-services-2024-25_1.pages.jsonl`\n- `strategies/pricing_framework_for_australian_public_hospital_services_2022-23_-_consultation.pages.jsonl`\n\n**Evidence contexts**:\n- Australian Public Hospital Services\n2024–25 (the Consultation Paper) and made minor\namendments to the ‘Evidence-based’ Process IHACPA will continue to use and annually\nGuideline, based on stakeholder feedback to the review the Pricing Guidelines to inform its\nNational Efficient Price Determination 2023–24. decision making and ensure they support\nongoing improvement to the efficiency and\nIn response to the Consultation Paper, the Centre accessibility of public hospital services.\nfor Aboriginal Economic Policy Research\nrecommended inclusion of a guideline to\n Source: `strategies/IHACPA-pricing-framework-australian-public-hospital-services-2024-25_1.pages.jsonl`\n- ons on the treatment of other\nCommonwealth programs, but received IHPA’s response\nfeedback from a small number of stakeholders.\nIn response to the feedback provided by Qld,\nIHPA’s PBS matching methodology will be\nreviewed and refined in the development of the\nNational Efficient Price Determination 2023–24\nFeedback received\n(NEP23).\nQld noted that some Tier 2 Non-Admitted For NEP23, IHPA will also review the potential\nServices Classification clinics have a impact of the PBS and MBS rebate systems on\nPharmaceutical Benefits Scheme (PBS) price the casemix and\n Source: `strategies/pricing_framework_for_australian_public_hospital_services_2022-23_-_consultation.pages.jsonl`\n\n### National Efficient Price Determination 2026\n\n**Type**: Determination\n**Confidence**: low\n**Mentions**: 2\n**Register search**: https://www.legislation.gov.au/search?query=National+Efficient+Price+Determination+2026\n\n**Sources**:\n- `strategies/pricing_framework_for_australian_public_hospital_services-consultation_report_1.pages.jsonl`\n\n**Evidence contexts**:\n- lity and quality\nof data to support such work. These limitations currently constrain IHACPA’s ability to incorporate these\nconsiderations into the national pricing model.\nPredictability of cost and emerging cost drivers and workforce challenges\nAs part of the National Efficient Price Determination 2026–27 (NEP26) development, IHACPA is analysing\ncost growth trends, with early indicators pointing to continued increases driven by workforce cost pressures.\nOngoing analysis will also focus on workforce and cost-of-living-related costs, such as wage agreements a\n Source: `strategies/pricing_framework_for_australian_public_hospital_services-consultation_report_1.pages.jsonl`\n- s for HACs and\nAHRs. While formal post-implementation reviews are not currently planned, IHACPA welcomes analysis and\nfeedback from states and territories to inform ongoing refinement of the models.\nIHACPA’s work program for safety and quality measures in the National Efficient Price Determination 2026–\n27 will focus on coronavirus disease 2019 (COVID-19) (including the suspension of temporary safety and\nquality measures for COVID-19 related episodes). Future work programs will explore geographic location (via\nremoteness), paediatric hospitals, indigenous s\n Source: `strategies/pricing_framework_for_australian_public_hospital_services-consultation_report_1.pages.jsonl`\n\n### Since the NEP Determination 2012\n\n**Type**: Determination\n**Confidence**: low\n**Mentions**: 2\n**Register search**: https://www.legislation.gov.au/search?query=Since+the+NEP+Determination+2012\n\n**Sources**:\n- `strategies/IHACPA-pricing-framework-australian-public-hospital-services-2024-25_1.pages.jsonl`\n- `strategies/pricing_framework_for_australian_public_hospital_services_2025-26.pages.jsonl`\n\n**Evidence contexts**:\n- h a COVID-19 diagnosis.\nCOVID-19 Response – Costing and Pricing\nGuidelines, as part of its introduction in NEP21, the\nIHACPA Pricing Framework for Australian Public Hospital Services 2024–25 19\n\n[page 20]\n4.2.1 Intensive Care Unit adjustment\nIHACPA’s decision\nSince the NEP Determination 2012–13 (NEP12),\nIHACPA has applied an ICU adjustment for specified Given the significant range of considerations\nICUs, listed in Appendix D of the NEP Determination proposed by stakeholders, a larger program\neach year. of work is required to ensure the ICU\nadjust\n Source: `strategies/IHACPA-pricing-framework-australian-public-hospital-services-2024-25_1.pages.jsonl`\n- the Assessment of Adjustments to the\nNational Pricing Model Policy available on IHACPA’s website. A list of all the adjustments IHACPA applies to the national\npricing model is available in the NEP24 on the IHACPA website.\n4.3.1 Intensive care unit adjustment\nSince the NEP Determination 2012–13 (NEP12), IHACPA has applied an intensive care unit (ICU) adjustment for\nspecified ICUs. The ICU adjustment was introduced to address legitimate and unavoidable cost variations associated with\ntreating patients in specified ICUs compared to other admitted p\n Source: `strategies/pricing_framework_for_australian_public_hospital_services_2025-26.pages.jsonl`\n\n### ABF) for the NEP Determination 2023\n\n**Type**: Determination\n**Confidence**: low\n**Mentions**: 1\n**Register search**: https://www.legislation.gov.au/search?query=ABF%29+for+the+NEP+Determination+2023\n\n**Sources**:\n- `strategies/Pricing-20Framework-20for-20Australian-20Public-20Hospital-20Services-202023-24-.pages.jsonl`\n\n**Evidence contexts**:\n- erse safety and New South Wales (NSW), Victoria, Queensland\nquality events. (Qld), Western Australia (WA) and Tasmania did\nnot support transitioning standalone hospitals\nproviding specialist mental health services from\nblock funding to activity based funding (ABF) for\nthe NEP Determination 2023–24 (NEP23), noting\nthere are significant differences in patient\nprofiles, service models, length of stay and\nresource utilisation that are not adequately\naccounted for in the Australian Mental Health\nCare Classification (AMHCC).\nIHACPA Pricing Framework for A\n Source: `strategies/Pricing-20Framework-20for-20Australian-20Public-20Hospital-20Services-202023-24-.pages.jsonl`\n\n### Addendum to the For the NEP Determination 2022\n\n**Type**: Determination\n**Confidence**: low\n**Mentions**: 1\n**Register search**: https://www.legislation.gov.au/search?query=Addendum+to+the+For+the+NEP+Determination+2022\n\n**Sources**:\n- `strategies/pricing_framework_for_australian_public_hospital_services_2022-23.pages.jsonl`\n\n**Evidence contexts**:\n- of other\nCommonwealth programs\nIHPA Pricing Framework for Australian Public Hospital Services 2022–23 24\n\n[page 28]\n8 Treatment of other\nCommonwealth programs\n8.1. Overview\nIHPA’s decision\nTo prevent a public hospital service being\nfunded more than once, the Addendum to the\nFor the NEP Determination 2022–23,\nNational Health Reform Agreement 2020–25\nIHPA does not propose any changes to\n(the Addendum) requires the Independent\nthe treatment of other Commonwealth\nHospital Pricing Authority (IHPA) to discount\nprograms.\nCommonwealth funding provided to public\nhospi\n Source: `strategies/pricing_framework_for_australian_public_hospital_services_2022-23.pages.jsonl`\n\n### Aged Care (Transitional Provisions) Act 1997\n\n**Type**: Act\n**Confidence**: low\n**Mentions**: 1\n**Register search**: https://www.legislation.gov.au/search?query=Aged+Care+%28Transitional+Provisions%29+Act+1997\n\n**Sources**:\n- `corporate-plans/2024-25.pages.jsonl`\n\n**Evidence contexts**:\n- ment funding\ndecisions\n• reviewing data, conducting studies and undertaking consultation for the purpose of providing aged care\ncosting and pricing advice\n• performing such functions as conferred by the Aged Care Act 1997 (the Aged Care Act) or the Aged Care\n(Transitional Provisions) Act 1997\n• performing other functions relating to aged care (if any) specified in regulations\n• undertaking other actions incidental or conducive to the performance of the above functions.\nIHACPA Work Program and Corporate Plan 2024–25 6\n\n[page 7]\nIHACPA also has the\n Source: `corporate-plans/2024-25.pages.jsonl`\n\n### Aged Care Rules 2025\n\n**Type**: Rules\n**Confidence**: low\n**Mentions**: 1\n**Register search**: https://www.legislation.gov.au/search?query=Aged+Care+Rules+2025\n\n**Sources**:\n- `pages/structure.html`\n\n**Evidence contexts**:\n- nd industrial bodies, governments, and consumers and their carers.\nAged Care Policy (Accommodation)\nThe functions of the Aged Care Policy (Accommodation) team are to review applications for\nrefundable accommodation deposits\nabove the maximum prescribed by the\nAged Care\nRules 2025\n. 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\nAged Care\nAct 2024\n.\nCorporate Affairs\nCommunications\nThe Communications te\n Source: `pages/structure.html`\n\n### Australian Hospital Patient Costing Standards NEP Determination 2026\n\n**Type**: Determination\n**Confidence**: low\n**Mentions**: 1\n**Register search**: https://www.legislation.gov.au/search?query=Australian+Hospital+Patient+Costing+Standards+NEP+Determination+2026\n\n**Sources**:\n- `strategies/Pricing_Framework_for_Australian_Public_Hospital_Services_2026-2027_2.pages.jsonl`\n\n**Evidence contexts**:\n- er the addendum, jurisdictions are\nrequired to work together with the national bodies to share and work towards best practice approaches to data\nquality and integrity. IHACPA continues to receive cost data for over 95% of admitted patient activity\nnationally.\nAustralian Hospital Patient Costing Standards\nNEP Determination 2026–27 (NEP26) is underpinned by 2023–24 cost data. For 2023–24, National Hospital\nCost Data Collection (NHCDC) submissions were guided by the Australian Hospital Patient Costing Standards\nVersion 4.2, which included minor updates to costing guidelines related to\n Source: `strategies/Pricing_Framework_for_Australian_Public_Hospital_Services_2026-2027_2.pages.jsonl`\n\n### COVID-19 NEP Determination 2023\n\n**Type**: Determination\n**Confidence**: low\n**Mentions**: 1\n**Register search**: https://www.legislation.gov.au/search?query=COVID-19+NEP+Determination+2023\n\n**Sources**:\n- `strategies/IHACPA-pricing-framework-australian-public-hospital-services-2024-25_1.pages.jsonl`\n\n**Evidence contexts**:\n- -19\nIn response to the observed clinical impacts of\ntreatment adjustment for a more limited set of\nCOVID-19 on cost and activity data, IHACPA\nAR-DRGS for NEP24 using an updated\nintroduced a COVID-19 treatment adjustment in the\nflagging methodology to identify COVID-19\nNEP Determination 2023–24 (NEP23). This\ntreatment episodes more accurately.\nadjustment aimed to recognise and account for\nlegitimate and unavoidable increased costs\nassociated with COVID-19 patients within certain\nAustralian Refined Diagnosis Related Groups\n(AR-DRGs) compared to pa\n Source: `strategies/IHACPA-pricing-framework-australian-public-hospital-services-2024-25_1.pages.jsonl`\n\n### COVID-19) for the National Efficient Price Determination 2026\n\n**Type**: Determination\n**Confidence**: low\n**Mentions**: 1\n**Register search**: https://www.legislation.gov.au/search?query=COVID-19%29+for+the+National+Efficient+Price+Determination+2026\n\n**Sources**:\n- `strategies/pricing_framework_for_australian_public_hospital_services-consultation_report_1.pages.jsonl`\n\n**Evidence contexts**:\n- e 20]\n4\nSetting the national\nefficient price\n\n[page 21]\n4. Setting the national efficient price\n4.1 Impact of COVID-19\nQuestion 5.\nAre there any barriers to removing the remaining temporary measures introduced to manage the\nimpact of coronavirus disease 2019 (COVID-19) for the National Efficient Price Determination\n2026–27 (NEP26)?\nFeedback received\nQueensland (Qld), the Northern Territory (NT), Human Genetics Society of Australasia (HGSA) and Catholic\nHealth Australia (CHA) supported removing the remaining temporary COVID-19 measures for NEP26.\nHowever, New South Wales (NSW\n Source: `strategies/pricing_framework_for_australian_public_hospital_services-consultation_report_1.pages.jsonl`\n\n### Commonwealth Government. on the NEP Determination 2023\n\n**Type**: Determination\n**Confidence**: low\n**Mentions**: 1\n**Register search**: https://www.legislation.gov.au/search?query=Commonwealth+Government.+on+the+NEP+Determination+2023\n\n**Sources**:\n- `strategies/pricing_framework_for_australian_public_hospital_services_2023-24_-_final.pages.jsonl`\n\n**Evidence contexts**:\n- Pricing\nthe 2020–21 activity and cost data to assess the\nAuthority (IHACPA) and expanding its role to\nshort-term pricing impacts of the coronavirus\ninclude the provision of aged care costing and\ndisease 2019 (COVID-19) pandemic response\npricing advice to the Commonwealth Government.\non the NEP Determination 2023–24 (NEP23).\nStakeholders provided feedback on changes to\nin-scope activity, volume, casemix and models of\n1.2 About this Pricing\ncare, ongoing workforce impacts and differences\nin reporting and public health policies across\nFramework\nstates and territories re\n Source: `strategies/pricing_framework_for_australian_public_hospital_services_2023-24_-_final.pages.jsonl`\n\n### Communicable Disease Incident of National Significance. For NEP Determination 2025\n\n**Type**: Determination\n**Confidence**: low\n**Mentions**: 1\n**Register search**: https://www.legislation.gov.au/search?query=Communicable+Disease+Incident+of+National+Significance.+For+NEP+Determination+2025\n\n**Sources**:\n- `strategies/Pricing_Framework_for_Australian_Public_Hospital_Services_2026-2027_2.pages.jsonl`\n\n**Evidence contexts**:\n- e the uncertainty around anticipated changes that\nCOVID-19 would introduce to the delivery of hospital care and support healthcare delivery to COVID-19\npatients in this context.\nIn October 2023, the Australian Government declared that COVID-19 was no longer a Communicable\nDisease Incident of National Significance.\nFor NEP Determination 2025–26 (NEP25), the temporary measures noted above were retained to account for\nthe ongoing impact of the COVID-19 pandemic response on hospital activity and cost data in 2022–23 and\nearlier.\nNEP26 will be primarily based on hospital activity and cost data from y\n Source: `strategies/Pricing_Framework_for_Australian_Public_Hospital_Services_2026-2027_2.pages.jsonl`\n\n### Efficient Price (NEP) Determination 2023\n\n**Type**: Determination\n**Confidence**: low\n**Mentions**: 1\n**Register search**: https://www.legislation.gov.au/search?query=Efficient+Price+%28NEP%29+Determination+2023\n\n**Sources**:\n- `strategies/Pricing-20Framework-20for-20Australian-20Public-20Hospital-20Services-202023-24-.pages.jsonl`\n\n**Evidence contexts**:\n- Classification of Health\nRelated Groups (AR-DRG) Version 11.0 and did not\nInterventions (ACHI)\nidentify any barriers to using AR-DRG Version 11.0\nto price admitted acute services for the National • consider the impact on and opportunities for\nEfficient Price (NEP) Determination 2023–24 classification refinement for other patient\n(NEP23). service categories\nThe Northern Territory (NT) recommended • establish pilot sites to identify system\nthat the Statement of Impact outline impacts capability and coding structure changes,\nat a jurisdicti\n Source: `strategies/Pricing-20Framework-20for-20Australian-20Public-20Hospital-20Services-202023-24-.pages.jsonl`\n\n### For the NEC Determination 2025\n\n**Type**: Determination\n**Confidence**: low\n**Mentions**: 1\n**Register search**: https://www.legislation.gov.au/search?query=For+the+NEC+Determination+2025\n\n**Sources**:\n- `strategies/pricing_framework_for_australian_public_hospital_services_2025-26.pages.jsonl`\n\n**Evidence contexts**:\n- Australian Government Departments of Education and Health and Aged Care on current funding arrangements, costs and\npayment systems for tertiary education in rural and remote areas. Further information is available in the consultation\nreport.\nIHACPA’s decision\nFor the NEC Determination 2025–26, IHACPA will continue to determine block funding amounts for teaching,\ntraining and research activity based on advice from states and territories.\nNext steps and future work\nIHACPA recognises the challenges in collecting teaching and training data particul\n Source: `strategies/pricing_framework_for_australian_public_hospital_services_2025-26.pages.jsonl`\n\n### For the NEP Determination 2020\n\n**Type**: Determination\n**Confidence**: low\n**Mentions**: 1\n**Register search**: https://www.legislation.gov.au/search?query=For+the+NEP+Determination+2020\n\n**Sources**:\n- `strategies/Pricing-20Framework-20for-20Australian-20Public-20Hospital-20Services-202021-E2-.pages.jsonl`\n\n**Evidence contexts**:\n- Admitted Services Classification: the\naddition of a clinical nurse specialist/allied health\nled clinic in chronic pain management.\nIHPA Pricing Framework for Australian Public Hospital Services 2021–22 19\n\n[page 23]\n6.4. Emergency care 6.5. Mental health care\nFor the NEP Determination 2020–21 (NEP20), IHPA commenced shadow pricing admitted\nIHPA used Urgency Related Groups Version 1.4 mental health services using the Australian\nto classify presentations to emergency Mental Health Care Classification (AMHCC)\ndepartments and Urgency Disposition Gr\n Source: `strategies/Pricing-20Framework-20for-20Australian-20Public-20Hospital-20Services-202021-E2-.pages.jsonl`\n\n### For the National Efficient Price Determination 2023\n\n**Type**: Determination\n**Confidence**: low\n**Mentions**: 1\n**Register search**: https://www.legislation.gov.au/search?query=For+the+National+Efficient+Price+Determination+2023\n\n**Sources**:\n- `strategies/pricing_framework_for_australian_public_hospital_services_2023-24_-_final.pages.jsonl`\n\n**Evidence contexts**:\n- isode of care with a sentinel For NEP23, IHACPA will use Version 3.1 of the\nevent, applicable to all hospitals, whether funded HACs list, available on the Commission’s\non an activity or block funded basis. website.\nIHACPA’s decision\nNext steps and future work\nFor the National Efficient Price\nDetermination 2023–24 (NEP23), IHACPA will IHACPA will consider stakeholder feedback\ncontinue to assign zero NWAU to episodes alongside feedback or directives received\nwith a sentinel event using Version 2.0 of from health ministers to inform\nthe Australian Sentinel Events List\n Source: `strategies/pricing_framework_for_australian_public_hospital_services_2023-24_-_final.pages.jsonl`\n\n### General List of In-Scope Public Hospital Services for the NEP Determination 2025\n\n**Type**: Determination\n**Confidence**: low\n**Mentions**: 1\n**Register search**: https://www.legislation.gov.au/search?query=General+List+of+In-Scope+Public+Hospital+Services+for+the+NEP+Determination+2025\n\n**Sources**:\n- `corporate-plans/2024-25.pages.jsonl`\n\n**Evidence contexts**:\n- l details of the public hospital services determined to be in‑scope for Commonwealth funding are provided in\nthe annual NEP Determination. In 2024–25, IHACPA will assess jurisdiction submissions for additional or altered\nin-scope services for inclusion on the General List of In-Scope Public Hospital Services for the NEP Determination\n2025–26 (NEP25).\nIHACPA Work Program and Corporate Plan 2024–25 9\n\n[page 10]\nc) National Efficient Price and National Efficient Cost Determinations for public hospital\nservices 2025–26\nDeliverable Timeframe\nFinalise decisions on jurisdictional submissions for legi\n Source: `corporate-plans/2024-25.pages.jsonl`\n\n### IHACPA Learn. For the NEP Determination 2025\n\n**Type**: Determination\n**Confidence**: low\n**Mentions**: 1\n**Register search**: https://www.legislation.gov.au/search?query=IHACPA+Learn.+For+the+NEP+Determination+2025\n\n**Sources**:\n- `strategies/pricing_framework_for_australian_public_hospital_services_2025-26-consultation_r.pages.jsonl`\n\n**Evidence contexts**:\n- n industry briefing for software vendors to facilitate automation in coding software in advance of implementation.\n• Development of targeted education for clinical coders and data users informed by the pilot and other feedback,\nwhich will be available through IHACPA Learn.\nFor the NEP Determination 2025–26 (NEP25), IHACPA intends to use ICD-10-AM/ACHI/ACS Thirteenth Edition, and\ncontinue to use Australian Refined Diagnosis Re\n\n_…truncated, open the .md file for the full content._", "global_initiatives_md": null, "strategy": { "reporting_period": "2024-25", "corporate_plan_period": "2024-25", "vision": null, "vision_source_page": null, "purposes": "IHACPA’s role pertaining to pricing and funding for public hospital services includes: determining the national efficient price (NEP) for health care services provided by public hospitals where the services are funded on an activity basis; determining the national efficient cost (NEC) for health care services provided by public hospitals where the services are block funded; developing block funding criteria and determining which hospitals, services and functions are eligible for block funding or a combination of activity based funding (ABF) and block funding; developing and specifying classification systems for health care and other services provided by public hospitals; determining adjustments to the NEP to reflect legitimate and unavoidable variations in the costs of delivering health care services; determining data requirements and data and coding standards to apply in relation to data to be provided by jurisdictions, including: data and coding standards to support uniform provision of data; and requirements and standards relating to patient demographic characteristics and other information relevant to classifying, costing and paying for public hospital functions; except where otherwise agreed between the Commonwealth and a state or territory – determining the public hospital functions that are to be funded in the state or territory by the Commonwealth. IHACPA’s role pertaining to the provision of advice on aged care costing and pricing matters to the Australian Government Minister for Health and Aged Care includes: providing aged care pricing advice about changes in the cost of care and methods for calculating amounts of subsidies to be paid for aged care services, for consideration in Australian Government funding decisions; reviewing data, conducting studies and undertaking consultation for the purpose of providing aged care costing and pricing advice; performing such functions as conferred by the Aged Care Act 1997 (the Aged Care Act) or the Aged Care (Transitional Provisions) Act 1997; performing other functions relating to aged care (if any) specified in regulations; undertaking other actions incidental or conducive to the performance of the above functions. [CP p.6]", "purposes_source_page": 6, "how_we_deliver": null, "how_we_deliver_source_page": null, "government_priorities": [ { "text": "Perform pricing functions", "source_page": 7 }, { "text": "Refine and develop hospital and aged care activity classification systems", "source_page": 7 }, { "text": "Refine and improve hospital and aged care costing", "source_page": 7 }, { "text": "Determine data requirements and collect data", "source_page": 7 }, { "text": "Investigate and make recommendations concerning cost-shifting and cross-border disputes", "source_page": 7 }, { "text": "Conduct independent and transparent decision-making and engage with stakeholders", "source_page": 7 } ], "outcomes": [ { "name": "Outcome 1: Efficient pricing for public hospital services", "description": "IHACPA’s role is to determine the national efficient price (NEP) and national efficient cost (NEC) for public hospital services, develop block funding criteria, and develop and specify classification systems for health care services provided by public hospitals.", "key_activities": [ "Development of the Pricing Framework for Australian Public Hospital Services", "Determination of in-scope public hospital services eligible for Commonwealth funding", "National Efficient Price and National Efficient Cost Determinations for public hospital services" ], "source_page": 9 }, { "name": "Outcome 2: Efficient pricing for aged care services", "description": "IHACPA’s role is to provide pricing advice for residential aged care services, including the development of the Pricing Framework for Australian Residential Aged Care Services.", "key_activities": [ "Development of Pricing Frameworks for Australian Aged Care Services", "Aged Care Pricing Advice" ], "source_page": 13 } ], "values": [ "integrity", "transparency", "expertise", "collaboration" ], "values_framework_name": null, "kpi_targets_2025_26": [ { "code": "NEP01", "measure": "National Efficient Price Determination", "target": "Stability or improvement", "source_page": 9 }, { "code": "NEC01", "measure": "National Efficient Cost Determination", "target": "Stability or improvement", "source_page": 9 } ], "kpi_results_2024_25": [ { "code": "NEP01", "measure": "National Efficient Price Determination", "result": "Target met", "status": "Achieved", "source_page": 35 }, { "code": "NEC01", "measure": "National Efficient Cost Determination", "result": "Target met", "status": "Achieved", "source_page": 35 } ], "_source_urls": { "annual_report_url": "", "corporate_plan_url": "https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf" } }, "ideas": [ { "entity_id": "B-004115", "entity_name": "Independent Health and Aged Care Pricing Authority Clinical Advisory Committee", "folder_name": "Independent-Health-and-Aged-Care-Pricing-Authority-Clinical-Advisory-Committee", "category": "Citizen Services", "scale": "small", "title": "Plain-language service pages and proactive status updates", "idea": "Rewrite high-volume pages and letters into plain language, add status notifications, and measure contact reduction.", "quote": "[Page 30]\nFeedback received\nStakeholders suggested the following measures to support the second year of transitioning community mental\nhealth care services to ABF under NEP26:\n• maintain or expand block funding arrangements for specialised or low-volume services that are not\nfinancially sustainable under ABF, to ensure continuity of care and equitable access\n• continue the composite ABF and block funding model in 2026–27 to support funding stability\n• undertake a national review of activity data quality and consistency across states and territories to\nassess readiness for further transition and to avoid premature implementation\n• consider systemic challenges in applying ABF to mental health services, including risks of\nunderfunding, workforce shortages, increasing complexity of patient presentations, and care episodes\ninvolving children or adolescents without the client present", "impact": "High", "effort": "Low", "proof": "Evidence-backed", "beneficiaries": "Citizens / service users", "source": "strategies/pricing_framework_for_australian_public_hospital_services-consultation_report_1.pdf (https://www.ihacpa.gov.au/sites/default/files/2025-12/pricing_framework_for_australian_public_hospital_services-consultation_report_1.pdf)", "implementation": [ "Pick one high-volume process or document family.", "Name an owner and baseline current volume, time, cost, and satisfaction.", "Run a 4-8 week pilot with clear before/after metrics.", "Publish lessons and decide whether to scale." ], "risks": [ "Privacy and data quality", "Change fatigue", "Unclear accountability", "Digital exclusion", "Low public trust if feedback is not acted on" ] }, { "entity_id": "B-004115", "entity_name": "Independent Health and Aged Care Pricing Authority Clinical Advisory Committee", "folder_name": "Independent-Health-and-Aged-Care-Pricing-Authority-Clinical-Advisory-Committee", "category": "Citizen Services", "scale": "large", "title": "Single front door for life-event based services", "idea": "Bundle services around life events so citizens can complete related steps across agencies in one journey.", "quote": "[Page 30]\nFeedback received\nStakeholders suggested the following measures to support the second year of transitioning community mental\nhealth care services to ABF under NEP26:\n• maintain or expand block funding arrangements for specialised or low-volume services that are not\nfinancially sustainable under ABF, to ensure continuity of care and equitable access\n• continue the composite ABF and block funding model in 2026–27 to support funding stability\n• undertake a national review of activity data quality and consistency across states and territories to\nassess readiness for further transition and to avoid premature implementation\n• consider systemic challenges in applying ABF to mental health services, including risks of\nunderfunding, workforce shortages, increasing complexity of patient presentations, and care episodes\ninvolving children or adolescents without the client present", "impact": "Very High", "effort": "High", "proof": "Evidence-backed", "beneficiaries": "Citizens / service users", "source": "strategies/pricing_framework_for_australian_public_hospital_services-consultation_report_1.pdf (https://www.ihacpa.gov.au/sites/default/files/2025-12/pricing_framework_for_australian_public_hospital_services-consultation_report_1.pdf)", "implementation": [ "Create a senior responsible owner and cross-functional delivery team.", "Map legislation, data, privacy, procurement, cyber, and workforce constraints.", "Co-design with users and frontline staff before technology selection.", "Stage delivery through pilots, benefits tracking, and public reporting." ], "risks": [ "Privacy and data quality", "Change fatigue", "Unclear accountability", "Digital exclusion", "Low public trust if feedback is not acted on" ] }, { "entity_id": "B-004115", "entity_name": "Independent Health and Aged Care Pricing Authority Clinical Advisory Committee", "folder_name": "Independent-Health-and-Aged-Care-Pricing-Authority-Clinical-Advisory-Committee", "category": "Data & Performance", "scale": "small", "title": "KPI evidence register with named owners", "idea": "Create a simple register mapping each KPI to source data, owner, frequency, target, and last result.", "quote": "[Page 35]\nPhysical Security\nStaff have annual security training\nPhysical security of staff,\nSecurity checks undertaken\nvisitors or contractors and\nasset security Use of asset registers\nSecurity risk register in place\n3.5 Performance measures\nSection 16EA of the Public Governance, Performance and Accountability Rule 2014 (the PGPA Rule) stipulates\nthe requirements around performance measures for Australian Government entities.", "impact": "High", "effort": "Low", "proof": "Evidence-backed", "beneficiaries": "Executives / Parliament / public", "source": "corporate-plans/2024-25.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf)", "implementation": [ "Pick one high-volume process or document family.", "Name an owner and baseline current volume, time, cost, and satisfaction.", "Run a 4-8 week pilot with clear before/after metrics.", "Publish lessons and decide whether to scale." ], "risks": [ "Privacy and data quality", "Change fatigue", "Unclear accountability" ] }, { "entity_id": "B-004115", "entity_name": "Independent Health and Aged Care Pricing Authority Clinical Advisory Committee", "folder_name": "Independent-Health-and-Aged-Care-Pricing-Authority-Clinical-Advisory-Committee", "category": "Data & Performance", "scale": "large", "title": "Outcome dashboard linking budget, delivery, and public impact", "idea": "Build a public-facing outcome dashboard showing spend, outputs, outcomes, and delivery confidence.", "quote": "[Page 35]\nPhysical Security\nStaff have annual security training\nPhysical security of staff,\nSecurity checks undertaken\nvisitors or contractors and\nasset security Use of asset registers\nSecurity risk register in place\n3.5 Performance measures\nSection 16EA of the Public Governance, Performance and Accountability Rule 2014 (the PGPA Rule) stipulates\nthe requirements around performance measures for Australian Government entities.", "impact": "Very High", "effort": "High", "proof": "Evidence-backed", "beneficiaries": "Executives / Parliament / public", "source": "corporate-plans/2024-25.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf)", "implementation": [ "Create a senior responsible owner and cross-functional delivery team.", "Map legislation, data, privacy, procurement, cyber, and workforce constraints.", "Co-design with users and frontline staff before technology selection.", "Stage delivery through pilots, benefits tracking, and public reporting." ], "risks": [ "Privacy and data quality", "Change fatigue", "Unclear accountability" ] }, { "entity_id": "B-004115", "entity_name": "Independent Health and Aged Care Pricing Authority Clinical Advisory Committee", "folder_name": "Independent-Health-and-Aged-Care-Pricing-Authority-Clinical-Advisory-Committee", "category": "Citizen Participation", "scale": "small", "title": "Consultation feedback summaries with response tracking", "idea": "Summarise consultation submissions by theme and publish what changed in response.", "quote": "Feedback from stakeholders also included\nrecommendations for undertaking the evaluation IHPA will continue to refine the methodology for\nprocess: the evaluation of the implemented safety and\nquality reforms, based on the feedback from\n- target specific outcomes, such as the stakeholders, in consultation with jurisdictions\nnumber, proportion and likelihood of and clinical experts.\nsentinel events, hospital acquired\ncomplications and avoidable hospital\nreadmissions in hospitals pre- and\npost-intervention\nIHPA Pricing Framework for Australian Public Hospital Services 2022–23 – Consultation Report 33", "impact": "High", "effort": "Low", "proof": "Evidence-backed", "beneficiaries": "Citizens / stakeholders / policy teams", "source": "strategies/pricing_framework_for_australian_public_hospital_services_2022-23_-_consultation.pdf (https://www.ihacpa.gov.au/sites/default/files/2022-08/pricing_framework_for_australian_public_hospital_services_2022-23_-_consultation_report.pdf)", "implementation": [ "Pick one high-volume process or document family.", "Name an owner and baseline current volume, time, cost, and satisfaction.", "Run a 4-8 week pilot with clear before/after metrics.", "Publish lessons and decide whether to scale." ], "risks": [ "Privacy and data quality", "Change fatigue", "Unclear accountability", "Digital exclusion", "Low public trust if feedback is not acted on" ] }, { "entity_id": "B-004115", "entity_name": "Independent Health and Aged Care Pricing Authority Clinical Advisory Committee", "folder_name": "Independent-Health-and-Aged-Care-Pricing-Authority-Clinical-Advisory-Committee", "category": "Citizen Participation", "scale": "large", "title": "Always-on policy participation platform", "idea": "Create a standing participation platform where citizens and stakeholders can propose, vote, and track ideas.", "quote": "Feedback from stakeholders also included\nrecommendations for undertaking the evaluation IHPA will continue to refine the methodology for\nprocess: the evaluation of the implemented safety and\nquality reforms, based on the feedback from\n- target specific outcomes, such as the stakeholders, in consultation with jurisdictions\nnumber, proportion and likelihood of and clinical experts.\nsentinel events, hospital acquired\ncomplications and avoidable hospital\nreadmissions in hospitals pre- and\npost-intervention\nIHPA Pricing Framework for Australian Public Hospital Services 2022–23 – Consultation Report 33", "impact": "Very High", "effort": "High", "proof": "Evidence-backed", "beneficiaries": "Citizens / stakeholders / policy teams", "source": "strategies/pricing_framework_for_australian_public_hospital_services_2022-23_-_consultation.pdf (https://www.ihacpa.gov.au/sites/default/files/2022-08/pricing_framework_for_australian_public_hospital_services_2022-23_-_consultation_report.pdf)", "implementation": [ "Create a senior responsible owner and cross-functional delivery team.", "Map legislation, data, privacy, procurement, cyber, and workforce constraints.", "Co-design with users and frontline staff before technology selection.", "Stage delivery through pilots, benefits tracking, and public reporting." ], "risks": [ "Privacy and data quality", "Change fatigue", "Unclear accountability", "Digital exclusion", "Low public trust if feedback is not acted on" ] }, { "entity_id": "B-004115", "entity_name": "Independent Health and Aged Care Pricing Authority Clinical Advisory Committee", "folder_name": "Independent-Health-and-Aged-Care-Pricing-Authority-Clinical-Advisory-Committee", "category": "Regulation & Policy", "scale": "small", "title": "Regulatory burden scan for forms, guidance, and reporting", "idea": "Identify the top 10 highest-friction reporting obligations and simplify guidance, forms, or evidence requirements.", "quote": "Strategic Objective One: Perform pricing functions\na) Development of the Pricing Framework for Australian Public Hospital Services 2025–26\nDeliverable Timeframe\nComplete the public consultation process for the Pricing Framework for July 2024\nAustralian Public Hospital Services 2025–26.", "impact": "High", "effort": "Low", "proof": "Evidence-backed", "beneficiaries": "Regulated entities / policy teams", "source": "corporate-plans/2024-25.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf)", "implementation": [ "Pick one high-volume process or document family.", "Name an owner and baseline current volume, time, cost, and satisfaction.", "Run a 4-8 week pilot with clear before/after metrics.", "Publish lessons and decide whether to scale." ], "risks": [ "Privacy and data quality", "Change fatigue", "Unclear accountability", "Regulatory capture", "Over-automation of judgement" ] }, { "entity_id": "B-004115", "entity_name": "Independent Health and Aged Care Pricing Authority Clinical Advisory Committee", "folder_name": "Independent-Health-and-Aged-Care-Pricing-Authority-Clinical-Advisory-Committee", "category": "Regulation & Policy", "scale": "large", "title": "Adaptive regulation program with live feedback loops", "idea": "Create an adaptive regulation model using sandboxes, industry data, risk scoring, and regular rule updates.", "quote": "Strategic Objective One: Perform pricing functions\na) Development of the Pricing Framework for Australian Public Hospital Services 2025–26\nDeliverable Timeframe\nComplete the public consultation process for the Pricing Framework for July 2024\nAustralian Public Hospital Services 2025–26.", "impact": "Very High", "effort": "High", "proof": "Evidence-backed", "beneficiaries": "Regulated entities / policy teams", "source": "corporate-plans/2024-25.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf)", "implementation": [ "Create a senior responsible owner and cross-functional delivery team.", "Map legislation, data, privacy, procurement, cyber, and workforce constraints.", "Co-design with users and frontline staff before technology selection.", "Stage delivery through pilots, benefits tracking, and public reporting." ], "risks": [ "Privacy and data quality", "Change fatigue", "Unclear accountability", "Regulatory capture", "Over-automation of judgement" ] }, { "entity_id": "B-004115", "entity_name": "Independent Health and Aged Care Pricing Authority Clinical Advisory Committee", "folder_name": "Independent-Health-and-Aged-Care-Pricing-Authority-Clinical-Advisory-Committee", "category": "Staff Productivity", "scale": "small", "title": "Reusable briefing and summary assistant for internal documents", "idea": "Create controlled templates for summarising reports, submissions, minutes, and ministerial briefs.", "quote": "[Page 14]\nThe timeframes for IHACPA’s initial public consultation and development of pricing advice are yet to be confirmed\nand will be informed by the requirements set out by the Australian Government Minister for Health and Aged\nCare.\ni) Aged Care Pricing Advice 2025–26\nDeliverable Timeframe\nProvide pricing advice to inform Australian Government decisions on July 2025\nresidential aged care and respite care funding for 2025–26.", "impact": "High", "effort": "Low", "proof": "Evidence-backed", "beneficiaries": "APS staff / executives", "source": "corporate-plans/2024-25.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf)", "implementation": [ "Pick one high-volume process or document family.", "Name an owner and baseline current volume, time, cost, and satisfaction.", "Run a 4-8 week pilot with clear before/after metrics.", "Publish lessons and decide whether to scale." ], "risks": [ "Privacy and data quality", "Change fatigue", "Unclear accountability", "Sensitive information leakage", "Inconsistent quality of generated drafts" ] }, { "entity_id": "B-004115", "entity_name": "Independent Health and Aged Care Pricing Authority Clinical Advisory Committee", "folder_name": "Independent-Health-and-Aged-Care-Pricing-Authority-Clinical-Advisory-Committee", "category": "Staff Productivity", "scale": "large", "title": "Department-wide knowledge and briefing platform", "idea": "Build a secure knowledge platform that lets staff search, summarise, and cite approved departmental material.", "quote": "[Page 14]\nThe timeframes for IHACPA’s initial public consultation and development of pricing advice are yet to be confirmed\nand will be informed by the requirements set out by the Australian Government Minister for Health and Aged\nCare.\ni) Aged Care Pricing Advice 2025–26\nDeliverable Timeframe\nProvide pricing advice to inform Australian Government decisions on July 2025\nresidential aged care and respite care funding for 2025–26.", "impact": "Very High", "effort": "High", "proof": "Evidence-backed", "beneficiaries": "APS staff / executives", "source": "corporate-plans/2024-25.pdf (https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf)", "implementation": [ "Create a senior responsible owner and cross-functional delivery team.", "Map legislation, data, privacy, procurement, cyber, and workforce constraints.", "Co-design with users and frontline staff before technology selection.", "Stage delivery through pilots, benefits tracking, and public reporting." ], "risks": [ "Privacy and data quality", "Change fatigue", "Unclear accountability", "Sensitive information leakage", "Inconsistent quality of generated drafts" ] }, { "entity_id": "B-004115", "entity_name": "Independent Health and Aged Care Pricing Authority Clinical Advisory Committee", "folder_name": "Independent-Health-and-Aged-Care-Pricing-Authority-Clinical-Advisory-Committee", "category": "Risk & Assurance", "scale": "small", "title": "Recommendation tracker for audits, reviews, and inquiries", "idea": "Publish a single internal tracker for audit/review recommendations, owners, due dates, and implementation evidence.", "quote": "Pricing and funding\nfor safety and quality\n9.1 Overview 9.3 Hospital acquired\ncomplications\nThe Independent Health and Aged Care\nPricing Authority (IHACPA) and the Australian\nA HAC is a complication that occurs during a\nCommission on Safety and Quality in Health Care\nhospital stay and for which clinical risk mitigation\n(the Commission) follow a collaborative work\nstrategies may reduce (but not necessarily\nprogram to incorporate safety and quality\neliminate) the risk of that complication occurring.\nmeasures into determining the national efficient\nprice (NEP), as required under the Addendum to\nIHACPA’s funding approach for HACs incorporates\nthe National Health Reform Agreement 2020–25\na risk adjustment model that reduces funding for\n(the Addendum).\nany episode of admitted acute care where a HAC\noccurs.", "impact": "High", "effort": "Low", "proof": "Evidence-backed", "beneficiaries": "Executives / assurance teams", "source": "strategies/pricing_framework_for_australian_public_hospital_services_2023-24_-_final.pdf (https://www.ihacpa.gov.au/sites/default/files/2022-12/pricing_framework_for_australian_public_hospital_services_2023-24_-_final.pdf)", "implementation": [ "Pick one high-volume process or document family.", "Name an owner and baseline current volume, time, cost, and satisfaction.", "Run a 4-8 week pilot with clear before/after metrics.", "Publish lessons and decide whether to scale." ], "risks": [ "Privacy and data quality", "Change fatigue", "Unclear accountability", "Regulatory capture", "Over-automation of judgement" ] }, { "entity_id": "B-004115", "entity_name": "Independent Health and Aged Care Pricing Authority Clinical Advisory Committee", "folder_name": "Independent-Health-and-Aged-Care-Pricing-Authority-Clinical-Advisory-Committee", "category": "Risk & Assurance", "scale": "large", "title": "Integrated assurance and lessons-learned system", "idea": "Create an assurance system that connects audit findings, risk registers, delivery reviews, and investment decisions.", "quote": "Pricing and funding\nfor safety and quality\n9.1 Overview 9.3 Hospital acquired\ncomplications\nThe Independent Health and Aged Care\nPricing Authority (IHACPA) and the Australian\nA HAC is a complication that occurs during a\nCommission on Safety and Quality in Health Care\nhospital stay and for which clinical risk mitigation\n(the Commission) follow a collaborative work\nstrategies may reduce (but not necessarily\nprogram to incorporate safety and quality\neliminate) the risk of that complication occurring.\nmeasures into determining the national efficient\nprice (NEP), as required under the Addendum to\nIHACPA’s funding approach for HACs incorporates\nthe National Health Reform Agreement 2020–25\na risk adjustment model that reduces funding for\n(the Addendum).\nany episode of admitted acute care where a HAC\noccurs.", "impact": "Very High", "effort": "High", "proof": "Evidence-backed", "beneficiaries": "Executives / assurance teams", "source": "strategies/pricing_framework_for_australian_public_hospital_services_2023-24_-_final.pdf (https://www.ihacpa.gov.au/sites/default/files/2022-12/pricing_framework_for_australian_public_hospital_services_2023-24_-_final.pdf)", "implementation": [ "Create a senior responsible owner and cross-functional delivery team.", "Map legislation, data, privacy, procurement, cyber, and workforce constraints.", "Co-design with users and frontline staff before technology selection.", "Stage delivery through pilots, benefits tracking, and public reporting." ], "risks": [ "Privacy and data quality", "Change fatigue", "Unclear accountability", "Regulatory capture", "Over-automation of judgement" ] } ], "legislation_administered": [], "artifacts": [ { "category": "corporate-plans", "year": "2024-25", "url": "https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf", "file": "corporate-plans/2024-25.pdf", "bytes": 913150, "link_text": "Download IHACPA Work Program and Corporate Plan 2024-25" }, { "category": "strategies", "year": "2025", "url": "https://www.ihacpa.gov.au/sites/default/files/2025-09/data_request_form_version_8.0.pdf", "file": "strategies/data_request_form_version_8.0.pdf", "bytes": 851553, "link_text": "Data Request Form" }, { "category": "strategies", "year": "2026-27", "url": "https://www.ihacpa.gov.au/sites/default/files/2026-01/Pricing_Framework_for_Australian_Public_Hospital_Services_2026-2027_2.PDF", "file": "strategies/Pricing_Framework_for_Australian_Public_Hospital_Services_2026-2027_2.pdf", "bytes": 727272, "link_text": "Download Pricing Framework for Australian Public Hospital Services 2026–27" }, { "category": "strategies", "year": "2026-27", "url": "https://www.ihacpa.gov.au/sites/default/files/2025-12/pricing_framework_for_australian_public_hospital_services-consultation_report_1.pdf", "file": "strategies/pricing_framework_for_australian_public_hospital_services-consultation_report_1.pdf", "bytes": 688277, "link_text": "Download Pricing Framework for Australian Public Hospital Services 2026–27 – Consultation Report" }, { "category": "strategies", "year": "2025-26", "url": "https://www.ihacpa.gov.au/sites/default/files/2024-12/pricing_framework_for_australian_public_hospital_services_2025-26.pdf", "file": "strategies/pricing_framework_for_australian_public_hospital_services_2025-26.pdf", "bytes": 830948, "link_text": "Download Pricing Framework for Australian Public Hospital Services 2025-26" }, { "category": "strategies", "year": "2025-26", "url": "https://www.ihacpa.gov.au/sites/default/files/2024-12/pricing_framework_for_australian_public_hospital_services_2025-26-consultation_report.pdf", "file": "strategies/pricing_framework_for_australian_public_hospital_services_2025-26-consultation_r.pdf", "bytes": 781190, "link_text": "Download Pricing Framework for Australian Public Hospital Services 2025-26 - Consultation Report" }, { "category": "strategies", "year": "2024-25", "url": "https://www.ihacpa.gov.au/sites/default/files/2024-01/IHACPA-pricing-framework-australian-public-hospital-services-2024-25_1.pdf", "file": "strategies/IHACPA-pricing-framework-australian-public-hospital-services-2024-25_1.pdf", "bytes": 889458, "link_text": "Download Pricing Framework for Australian Public Hospital Services 2024-25" }, { "category": "strategies", "year": "2024-25", "url": "https://www.ihacpa.gov.au/sites/default/files/2023-12/IHACPA-pricing-framework-australian-public-hospital-services-2024-25-consultation-report.PDF", "file": "strategies/IHACPA-pricing-framework-australian-public-hospital-services-2024-25-consultatio.pdf", "bytes": 973228, "link_text": "Download Pricing Framework for Australian Public Hospital Services 2024-25 - Consultation Report" }, { "category": "strategies", "year": "2023-24", "url": "https://www.ihacpa.gov.au/sites/default/files/2022-12/pricing_framework_for_australian_public_hospital_services_2023-24_-_final.pdf", "file": "strategies/pricing_framework_for_australian_public_hospital_services_2023-24_-_final.pdf", "bytes": 919925, "link_text": "Download Pricing Framework for Australian Public Hospital Services 2023-24" }, { "category": "strategies", "year": "2023-24", "url": "https://www.ihacpa.gov.au/sites/default/files/2022-12/Pricing%20Framework%20for%20Australian%20Public%20Hospital%20Services%202023-24%20-%20Consultation%20Report%20-%20Final.PDF", "file": "strategies/Pricing-20Framework-20for-20Australian-20Public-20Hospital-20Services-202023-24-.pdf", "bytes": 997439, "link_text": "Download Pricing Framework for Australian Public Hospital Services 2023-24 - Consultation Report" }, { "category": "strategies", "year": "2022-23", "url": "https://www.ihacpa.gov.au/sites/default/files/2022-08/pricing_framework_for_australian_public_hospital_services_2022-23.pdf", "file": "strategies/pricing_framework_for_australian_public_hospital_services_2022-23.pdf", "bytes": 1116736, "link_text": "Download Pricing Framework for Australian Public Hospital Services 2022-23" }, { "category": "strategies", "year": "2022-23", "url": "https://www.ihacpa.gov.au/sites/default/files/2022-08/pricing_framework_for_australian_public_hospital_services_2022-23_-_consultation_report.pdf", "file": "strategies/pricing_framework_for_australian_public_hospital_services_2022-23_-_consultation.pdf", "bytes": 1371444, "link_text": "Download Pricing Framework for Australian Public Hospital Services 2022-23 - Consultation Report" }, { "category": "strategies", "year": "2021-22", "url": "https://www.ihacpa.gov.au/sites/default/files/2022-02/Pricing%20Framework%20for%20Australian%20Public%20Hospital%20Services%202021%E2%80%9322.pdf", "file": "strategies/Pricing-20Framework-20for-20Australian-20Public-20Hospital-20Services-202021-E2-.pdf", "bytes": 1122945, "link_text": "Download Pricing Framework for Australian Public Hospital Services 2021–22" }, { "category": "other-pdfs", "year": null, "url": "https://engage.ihacpa.gov.au/ndis-pricing/online-submission/supporting_documents/Easy%20Read%20A%20Fresh%20Approach%20to%20NDIS%20Pricing.pdf", "file": "other-pdfs/Easy-20Read-20A-20Fresh-20Approach-20to-20NDIS-20Pricing.pdf", "bytes": 2303655, "link_text": "Easy Read - A fresh approach to pricing - we want to know what you think" } ], "_meta": { "snapshot_built_at": "2026-05-13T11:02:52+00:00", "strategy_brief_meta": { "model": "nova-micro", "folder": "Independent-Health-and-Aged-Care-Pricing-Authority-Clinical-Advisory-Committee", "annual_report": { "file": null, "url": "", "year": null }, "corporate_plan": { "file": "corporate-plans\\2024-25.txt", "url": "https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf", "year": "2024-25" }, "usage": { "input_tokens": 10778, "output_tokens": 1150, 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