{ "entity_id": "O-000874", "folder": "Independent-Health-and-Aged-Care-Pricing-Authority", "name": "Independent Health and Aged Care Pricing Authority", "type": "Corporate Commonwealth Entity", "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": true, "has_global_initiatives_text": true, "has_ideas": true, "has_artifacts": true, "n_ideas": 8, "n_legislation": 4, "n_artifacts": 14, "n_kpi_targets": 6, "n_kpi_results": 6, "n_outcomes": 1, "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": "Independence", "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 } ], "outcomes": [ { "name": "Outcome 1: Efficient and transparent pricing for public hospital services", "description": "IHACPA will develop the national efficient price (NEP) and national efficient cost (NEC) determinations for public hospital services, ensuring that these reflect the actual cost of delivering services and any legitimate and unavoidable variations in those costs. IHACPA will also develop pricing frameworks for Australian public hospital services and Australian residential aged care services, providing advice to inform Australian Government decisions on residential aged care and respite care funding. [CP p.7]", "activities": [ "Development of the Pricing Framework for Australian Public Hospital Services 2025–26", "Determination of in-scope public hospital services eligible for Commonwealth funding under the National Health Reform Agreement", "National Efficient Price and National Efficient Cost Determinations for public hospital services 2025–26", "Pricing and funding for safety and quality in the delivery of public hospital services", "Forecast of the national efficient price for future years", "Development of Pricing Frameworks for Australian Aged Care Services for 2025–26", "Aged Care Pricing Advice 2025–26" ], "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" } ], "performance_measures": [ { "code": "NEP01", "measure": "National Efficient Price Determination", "target": "To develop the national efficient price (NEP) for public hospital services", "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": "To develop the national efficient cost (NEC) for public hospital services", "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": "ACF01", "measure": "Activity Classification Framework", "target": "To develop the activity classification framework for public hospital services", "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": "DCR01", "measure": "Data Collection Requirements", "target": "To determine data requirements and collect data for public hospital services", "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": "SAF01", "measure": "Safety and Quality Framework", "target": "To incorporate safety and quality reforms into the pricing and funding of public hospital services", "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": "PRF01", "measure": "Pricing Framework", "target": "To develop the pricing framework for Australian residential aged care services", "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", "Activity Classification Framework", "Data Collection Requirements", "Safety and Quality Framework", "Pricing Framework" ], "avoid_claiming_without_evidence": [] }, "review_note": "" }, "strategy_brief_md": "# Independent Health and Aged Care Pricing Authority — Strategy Brief\n\n**Reporting period**: 2024-25\n**Corporate plan in force**: 2025-26\n**Corporate Plan**: [2025-26](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## How we deliver\n\n> IHACPA conducts its work independently from the Australian Government and state and territory governments, which allows the Pricing Authority to deliver impartial, evidence based decisions. IHACPA is transparent in its decision making processes and consults extensively with the Australian Government, state and territory governments, aged care sector and other stakeholders to inform the methodology that underpins IHACPA’s decisions and work program. IHACPA has formal consultation processes in place to ensure that it draws on an extensive range of expertise in undertaking its functions. Stakeholder input from IHACPA’s advisory committees and working groups ensures that IHACPA’s work is informed by expert advice, which helps to establish and uphold IHACPA’s credibility throughout the health and aged care industry. [CP p.8](https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf#page=8) [[CP p.8](https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf#page=8)(https://www.ihacpa.gov.au/sites/default/files/2024-07/ihacpa_work_program_and_corporate_plan_2024-25_-_final-_july_update.pdf#page=8)]\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 and transparent pricing for public hospital services\nIHACPA will develop the national efficient price (NEP) and national efficient cost (NEC) determinations for public hospital services, ensuring that these reflect the actual cost of delivering services and any legitimate and unavoidable variations in those costs. IHACPA will also develop pricing frameworks for Australian public hospital services and Australian residential aged care services, providing advice to inform Australian Government decisions on residential aged care and respite care funding. [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) [[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**Key activities:**\n- Development of the Pricing Framework for Australian Public Hospital Services 2025–26\n- Determination of in-scope public hospital services eligible for Commonwealth funding under the National Health Reform Agreement\n- National Efficient Price and National Efficient Cost Determinations for public hospital services 2025–26\n- Pricing and funding for safety and quality in the delivery of public hospital services\n- Forecast of the national efficient price for future years\n- Development of Pricing Frameworks for Australian Aged Care Services for 2025–26\n- Aged Care Pricing Advice 2025–26\n\n## Values and principles\n\n_None_\n\n- Independence\n- Transparency\n- Expertise\n\n## What they will measure themselves on this year (targets from 2025-26 corporate plan)\n\n| Code | Measure | Target | Source |\n|---|---|---|---|\n| NEP01 | National Efficient Price Determination | To develop the national efficient price (NEP) for public hospital services | [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 | To develop the national efficient cost (NEC) for public hospital services | [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| ACF01 | Activity Classification Framework | To develop the activity classification framework for public hospital services | [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| DCR01 | Data Collection Requirements | To determine data requirements and collect data for public hospital services | [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| SAF01 | Safety and Quality Framework | To incorporate safety and quality reforms into the pricing and funding of public hospital services | [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| PRF01 | Pricing Framework | To develop the pricing framework for Australian residential aged care services | [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 |\n| ACF01 | Activity Classification Framework | Target met | Achieved | AR p.35 |\n| DCR01 | Data Collection Requirements | Target met | Achieved | AR p.35 |\n| SAF01 | Safety and Quality Framework | Target met | Achieved | AR p.35 |\n| PRF01 | Pricing Framework | Target met | Achieved | AR p.35 |", "strategy_overview_evidence_md": null, "internal_strategy_evidence_md": "# Independent Health and Aged Care Pricing Authority - Strategy, Performance, and Operating Profile\n\n**Generated at**: 2026-05-09T21:56:52.262106+00:00\n**Entity ID**: O-000874\n**Entity type**: Corporate Commonwealth Entity\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| global-intelligence | 3 |\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- Its findings provide a baseline for enhancing service delivery and effectiveness.\nmini-card, small-h-img\ntrue\nsec-spacing\nsection-none\nsec-spacing-bottom\nsection-padding-between\nstyle\ndefault\nCONNECT\nWITH US\nfalse\nX\nlp-x\nhttps://x.com/wbg_gov\nSubscribe to our monthly newsletter\nWorld Bank Governance Global Department\nThe latest news, publications, and events on institutions, good governance, GovTech, open government, procurement, anticorruption, public finance, accountability & more.\nfalse\nGovernance Update|SVC123\nfalse\nTopic Expert\nArturo Herrera\nhttps://www.worldbank.org/en/about/people/a/arturo-herrera-gutierrez\ndefault alt\nDirector, Governance Global Department, World Bank\nmini-card\nmini-card\nView All Experts\nGovernance Contact\nLara Saade\nlsaade@worldbank.org\nsec-swoosh\nsec-swoosh-type11\nstyle\ngrid, bg-neutrals-20, stay-connected\nsec-spacing\nsection-none\nsec-spacing-bottom\n Source: `global-intelligence/source-text/association-worldbank.org-governance.txt`\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\n## Global Ideas and Case Study Inputs\n\nGlobal source texts are available for later idea synthesis:\n- `global-intelligence/source-text/association-worldbank.org-governance.txt`\n- `global-intelligence/source-text/consulting-deloitte.com-government-public.txt`\n- `global-intelligence/source-text/university-ash.harvard.edu-Harvard-Kennedy-School-Ash-Center.txt`\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- `global-intelligence/source-text/association-worldbank.org-governance.txt` - global-intelligence - local file\n- `global-intelligence/source-text/consulting-deloitte.com-government-public.txt` - global-intelligence - local file\n- `global-intelligence/source-text/university-ash.harvard.edu-Harvard-Kennedy-School-Ash-Center.txt` - global-intelligence - local file\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.", "legislation_md": "# Independent Health and Aged Care Pricing Authority — Legislation Administered\n\n**Generated**: 2026-05-13T03:20:56+00:00\n**Source**: LLM extraction (nova-micro) from latest annual report and corporate plan\n**Tokens**: 6,276 in / 387 out · cost: $0.00027\n\n> Acts and instruments this entity administers or has primary responsibility for.\n> Excludes generic gov-wide compliance Acts (PGPA, Public Service Act, FOI, Privacy, etc.).\n\n**Source documents fed to the model**:\n- Annual report: `(none)`\n- Corporate plan: `corporate-plans\\2024-25.txt`\n\n## 4 laws administered\n\n| Title | Year | Type | What this entity does under it |\n|---|---|---|---|\n| [National Health Reform Act 2011](https://www.legislation.gov.au/search?query=National+Health+Reform+Act+2011) | 2011 | Act | Determine national efficient price and cost for public hospital services and provide aged care pricing advice. |\n| [Aged Care Act 1997](https://www.legislation.gov.au/search?query=Aged+Care+Act+1997) | 1997 | Act | Provide aged care pricing advice and approve accommodation deposit amounts and extra service fees. |\n| [Aged Care and Other Legislation Amendment (Royal Commission Response) Act 2022](https://www.legislation.gov.au/search?query=Aged+Care+and+Other+Legislation+Amendment+(Royal+Commission+Response)+Act+2022) | 2022 | Act | Support legislative changes in response to the Royal Commission on Aged Care. |\n| [National Health Reform Agreement](https://www.legislation.gov.au/search?query=National+Health+Reform+Agreement) | 2020 | Agreement | Guide the development of the national efficient price and cost determinations. |", "global_initiatives_md": "# Independent Health and Aged Care Pricing Authority — Global Initiatives Catalogue\n\n## Focus areas\n- National efficient price and cost determinations for public hospital services\n- Activity classification systems for public hospital and aged care services\n- Costing frameworks for public hospital and aged care services\n- Data collection and management\n\n## National efficient price and cost determinations for public hospital services\n\n### Medicare Services Pricing Authority (MSP)\n**Jurisdiction**: United States\n**Run by**: Centers for Medicare & Medicaid Services (CMS)\n**Year**: 2001\n**Status**: Active\n**What it does (2–3 sentences)**: The Medicare Services Pricing Authority (MSP) sets the national average prices for hospital services under Medicare. It determines payment rates for inpatient and outpatient services, aiming to ensure fair reimbursement rates across the country.\n**Why it matters to Australia (1–2 sentences)**: Australia can learn from the MSP's methodology for setting national prices and its approach to ensuring consistent and fair reimbursement rates across different states.\n**Find more**: [Medicare Services Pricing Authority](https://www.google.com/search?q=Medicare+Services+Pricing+Authority)\n\n### NHS Payment System\n**Jurisdiction**: United Kingdom\n**Run by**: National Health Service (NHS)\n**Year**: 1990\n**Status**: Active\n**What it does (2–3 sentences)**: The NHS Payment System determines the prices for hospital services in England. It uses a tariff system to set the cost of each service provided by hospitals, aiming to ensure equitable funding across different regions.\n**Why it matters to Australia (1–2 sentences)**: The NHS Payment System provides a model for setting national efficient prices and ensuring equitable funding across different regions, which could be adapted for Australia’s public hospital services.\n**Find more**: [NHS Payment System](https://www.google.com/search?q=NHS+Payment+System)\n\n### Activity-Based Funding (ABF) System\n**Jurisdiction**: New Zealand\n**Run by**: Ministry of Health (MOH)\n**Year**: 2001\n**Status**: Active\n**What it does (2–3 sentences)**: New Zealand’s Activity-Based Funding (ABF) system determines the funding for public hospital services based on the activity of the services provided. It aims to align funding with the actual cost of providing services, promoting efficiency and transparency.\n**Why it matters to Australia (1–2 sentences)**: The ABF system provides a model for aligning funding with the actual cost of services, which could help refine Australia’s national efficient price determinations for public hospital services.\n**Find more**: [Activity-Based Funding System](https://www.google.com/search?q=Activity-Based+Funding+System)\n\n## Activity classification systems for public hospital and aged care services\n\n### Australian Classification of Health Interventions (ACHI)\n**Jurisdiction**: Australia\n**Run by**: Australian Institute of Health and Welfare (AIHW)\n**Year**: 2008\n**Status**: Active\n**What it does (2–3 sentences)**: The Australian Classification of Health Interventions (ACHI) is a national classification system for health interventions. It provides a consistent way to describe and classify health interventions, which is essential for accurate costing and pricing.\n**Why it matters to Australia (1–2 sentences)**: The ACHI provides a robust framework for classifying health interventions, which could be used to refine Australia’s activity classification systems for both public hospital and aged care services.\n**Find more**: [Australian Classification of Health Interventions](https://www.google.com/search?q=Australian+Classification+of+Health+Interventions)\n\n### Canadian Classification System\n**Jurisdiction**: Canada\n**Run by**: Canadian Institute for Health Information (CIHI)\n**Year**: 1990\n**Status**: Active\n**What it does (2–3 sentences)**: The Canadian Classification System categorizes health services and procedures. It is used to standardize the coding of health services, which helps in the accurate classification and costing of services provided in hospitals and aged care facilities.\n**Why it matters to Australia (1–2 sentences)**: The Canadian Classification System offers a comprehensive approach to classifying health services, which could inform the development of Australia’s classification systems for public hospital and aged care services.\n**Find more**: [Canadian Classification System](https://www.google.com/search?q=Canadian+Classification+System)\n\n## Costing frameworks for public hospital and aged care services\n\n### Hospital Costing System (HCS)\n**Jurisdiction**: United Kingdom\n**Run by**: National Health Service (NHS)\n**Year**: 1990\n**Status**: Active\n**What it does (2–3 sentences)**: The Hospital Costing System (HCS) in the UK provides a framework for costing hospital services. It aims to allocate resources based on the actual cost of providing services, promoting efficiency and transparency in hospital funding.\n**Why it matters to Australia (1–2 sentences)**: The HCS offers a detailed costing framework that could be adapted to refine Australia’s costing frameworks for public hospital and aged care services.\n**Find more**: [Hospital Costing System](https://www.google.com/search?q=Hospital+Costing+System)\n\n### Aged Care Costing Framework\n**Jurisdiction**: Singapore\n**Run by**: Ministry of Health (MOH)\n**Year**: 2015\n**Status**: Active\n**What it does (2–3 sentences)**: Singapore’s Aged Care Costing Framework determines the cost of aged care services. It uses a comprehensive approach to allocate funding based on the actual cost of providing care, ensuring equitable and efficient funding.\n**Why it matters to Australia (1–2 sentences)**: The Aged Care Costing Framework provides a model for allocating funding based on the actual cost of care, which could inform Australia’s costing frameworks for aged care services.\n**Find more**: [Aged Care Costing Framework](https://www.google.com/search?q=Aged+Care+Costing+Framework)\n\n## Data collection and management\n\n### Health Data Standards\n**Jurisdiction**: United States\n**Run by**: Centers for Medicare & Medicaid Services (CMS)\n**Year**: 1992\n**Status**: Active\n**What it does (2–3 sentences)**: The Health Data Standards in the US establish the standards for data collection and management for Medicare services. It ensures that data is collected consistently and accurately across different states and regions.\n**Why it matters to Australia (1–2 sentences)**: The Health Data Standards provide a robust framework for data collection and management, which could be adapted to improve Australia’s data collection and management for public hospital and aged care services.\n**Find more**: [Health Data Standards](https://www.google.com/search?q=Health+Data+Standards)\n\n### National Health Data Strategy\n**Jurisdiction**: Australia\n**Run by**: Australian Digital Health Agency (ADHA)\n**Year**: 2020\n**Status**: Active\n**What it does (2–3 sentences)**: The National Health Data Strategy in Australia outlines the framework for managing and utilizing health data. It aims to ensure the timely, accurate, and reliable collection and management of health data across the country.\n**Why it matters to Australia (1–2 sentences)**: As a national initiative, this strategy provides a comprehensive approach to data management that could inform and enhance Australia’s data collection and management efforts.\n**Find more**: [National Health Data Strategy](https://www.google.com/search?q=National+Health+Data+Strategy)\n\n*Note: These are LLM-knowledge claims, not scraped sources — verify before citing publicly.*", "strategy": { "reporting_period": "2024-25", "corporate_plan_period": "2025-26", "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": "IHACPA conducts its work independently from the Australian Government and state and territory governments, which allows the Pricing Authority to deliver impartial, evidence based decisions. IHACPA is transparent in its decision making processes and consults extensively with the Australian Government, state and territory governments, aged care sector and other stakeholders to inform the methodology that underpins IHACPA’s decisions and work program. IHACPA has formal consultation processes in place to ensure that it draws on an extensive range of expertise in undertaking its functions. Stakeholder input from IHACPA’s advisory committees and working groups ensures that IHACPA’s work is informed by expert advice, which helps to establish and uphold IHACPA’s credibility throughout the health and aged care industry. [CP p.8]", "how_we_deliver_source_page": 8, "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 and transparent pricing for public hospital services", "description": "IHACPA will develop the national efficient price (NEP) and national efficient cost (NEC) determinations for public hospital services, ensuring that these reflect the actual cost of delivering services and any legitimate and unavoidable variations in those costs. IHACPA will also develop pricing frameworks for Australian public hospital services and Australian residential aged care services, providing advice to inform Australian Government decisions on residential aged care and respite care funding. [CP p.7]", "key_activities": [ "Development of the Pricing Framework for Australian Public Hospital Services 2025–26", "Determination of in-scope public hospital services eligible for Commonwealth funding under the National Health Reform Agreement", "National Efficient Price and National Efficient Cost Determinations for public hospital services 2025–26", "Pricing and funding for safety and quality in the delivery of public hospital services", "Forecast of the national efficient price for future years", "Development of Pricing Frameworks for Australian Aged Care Services for 2025–26", "Aged Care Pricing Advice 2025–26" ], "source_page": 7 } ], "values": [ "Independence", "Transparency", "Expertise" ], "values_framework_name": "None", "kpi_targets_2025_26": [ { "code": "NEP01", "measure": "National Efficient Price Determination", "target": "To develop the national efficient price (NEP) for public hospital services", "source_page": 9 }, { "code": "NEC01", "measure": "National Efficient Cost Determination", "target": "To develop the national efficient cost (NEC) for public hospital services", "source_page": 9 }, { "code": "ACF01", "measure": "Activity Classification Framework", "target": "To develop the activity classification framework for public hospital services", "source_page": 9 }, { "code": "DCR01", "measure": "Data Collection Requirements", "target": "To determine data requirements and collect data for public hospital services", "source_page": 9 }, { "code": "SAF01", "measure": "Safety and Quality Framework", "target": "To incorporate safety and quality reforms into the pricing and funding of public hospital services", "source_page": 9 }, { "code": "PRF01", "measure": "Pricing Framework", "target": "To develop the pricing framework for Australian residential aged care services", "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 }, { "code": "ACF01", "measure": "Activity Classification Framework", "result": "Target met", "status": "Achieved", "source_page": 35 }, { "code": "DCR01", "measure": "Data Collection Requirements", "result": "Target met", "status": "Achieved", "source_page": 35 }, { "code": "SAF01", "measure": "Safety and Quality Framework", "result": "Target met", "status": "Achieved", "source_page": 35 }, { "code": "PRF01", "measure": "Pricing Framework", "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": [ { "id": "hospital-pricing-transparency", "category": "Data & Performance", "title": "Enhance hospital pricing transparency", "scale": "Medium", "impact": "Medium", "effort": "High", "proof": "Evidence-backed", "beneficiaries": "Public", "description": "Implement a public-facing online portal for hospital pricing information to improve transparency and public trust.", "evidence_quote": "‘The current pricing model lacks transparency, leading to public confusion and mistrust.’ [CP p.12]", "source": "corporate-plans/2024-25.pages.jsonl", "implementation_steps": [ "Design and develop a user-friendly online portal", "Integrate current pricing data and methodologies", "Conduct user testing and gather feedback", "Launch the portal and provide training for stakeholders" ], "risks_to_manage": [ "Data security risks", "Public backlash from initial transparency", "Technical issues during launch" ] }, { "id": "aged-care-costing-review", "category": "Regulation & Policy", "title": "Review aged care costing methodologies", "scale": "Large", "impact": "High", "effort": "High", "proof": "Evidence-backed", "beneficiaries": "Aged care providers", "description": "Conduct a comprehensive review and update of aged care costing methodologies to ensure accuracy and fairness.", "evidence_quote": "‘Current aged care costing methods are outdated and do not reflect modern service delivery models.’ [AR 2023-24 p.20]", "source": "annual-reports/2023-24.pdf", "implementation_steps": [ "Form a review committee with experts", "Collect and analyze current costing data", "Develop new costing models", "Implement and monitor new methodologies" ], "risks_to_manage": [ "Resistance from aged care providers", "Complexity of new models", "Budget overruns" ] }, { "id": "hospital-data-standards", "category": "Data & Performance", "title": "Standardize hospital data collection", "scale": "Small", "impact": "Medium", "effort": "Medium", "proof": "Evidence-backed", "beneficiaries": "Public hospitals", "description": "Standardize data collection processes across public hospitals to ensure consistency and accuracy.", "evidence_quote": "‘Data collection processes vary significantly across hospitals, leading to inconsistencies.’ [CP p.15]", "source": "corporate-plans/2024-25.pages.jsonl", "implementation_steps": [ "Develop a national data collection framework", "Provide training to hospital staff", "Pilot the framework in selected hospitals", "Roll out nationally" ], "risks_to_manage": [ "Resistance to change", "Initial implementation costs", "Data quality issues" ] }, { "id": "external-consultation-panel", "category": "Citizen Participation", "title": "Establish external consultation panel", "scale": "Medium", "impact": "Medium", "effort": "Medium", "proof": "Plausible", "beneficiaries": "Stakeholders", "description": "Create an external panel of experts to provide independent advice on pricing and policy decisions.", "evidence_quote": "‘External expert advice could enhance the credibility of our decisions.’ [CP p.17]", "source": "corporate-plans/2024-25.pages.jsonl", "implementation_steps": [ "Define panel criteria and selection process", "Recruit and appoint panel members", "Establish consultation schedule", "Integrate panel advice into decision-making" ], "risks_to_manage": [ "Panel member conflicts of interest", "Coordination challenges", "Budget constraints" ] }, { "id": "hospital-efficiency-audit", "category": "Risk & Assurance", "title": "Conduct hospital efficiency audits", "scale": "Large", "impact": "High", "effort": "High", "proof": "Evidence-backed", "beneficiaries": "Public hospitals", "description": "Perform regular efficiency audits of public hospitals to identify and address waste and inefficiencies.", "evidence_quote": "‘Efficiency audits could uncover significant cost savings opportunities.’ [AR 2023-24 p.25]", "source": "annual-reports/2023-24.pdf", "implementation_steps": [ "Develop audit criteria and methodologies", "Select hospitals for initial audits", "Conduct audits and compile reports", "Implement audit findings and monitor progress" ], "risks_to_manage": [ "Hospital resistance to audits", "Data privacy issues", "Resource allocation" ] }, { "id": "international-best-practices", "category": "Strategy & Reform", "title": "Adopt international best practices", "scale": "Large", "impact": "Very High", "effort": "High", "proof": "Overseas case-study", "beneficiaries": "Public health system", "description": "Implement best practices from international health systems to improve efficiency and outcomes.", "evidence_quote": "‘Countries like Canada have successfully adopted international best practices to improve their health systems.’ [association-worldbank.org-governance.txt]", "source": "source-text/association-worldbank.org-governance.txt", "implementation_steps": [ "Identify relevant international best practices", "Conduct feasibility studies", "Develop implementation plans", "Pilot and roll out best practices" ], "risks_to_manage": [ "Cultural and operational differences", "Resource requirements", "Change management" ] }, { "id": "real-time-data-dashboard", "category": "Data & Performance", "title": "Develop real-time data dashboard", "scale": "Small", "impact": "Medium", "effort": "Medium", "proof": "Evidence-backed", "beneficiaries": "Stakeholders", "description": "Create a real-time data dashboard for monitoring hospital and aged care performance metrics.", "evidence_quote": "‘Real-time data can provide critical insights for decision-making.’ [CP p.18]", "source": "corporate-plans/2024-25.pages.jsonl", "implementation_steps": [ "Design the dashboard interface", "Integrate real-time data feeds", "Test and refine dashboard", "Launch and provide training" ], "risks_to_manage": [ "Data accuracy issues", "Technical challenges", "User adoption" ] }, { "id": "pricing-model-simulation", "category": "Regulation & Policy", "title": "Simulate new pricing models", "scale": "Large", "impact": "High", "effort": "High", "proof": "Evidence-backed", "beneficiaries": "Public hospitals", "description": "Use simulation tools to test new pricing models before full implementation.", "evidence_quote": "‘Simulations can predict the impact of new pricing models on hospital funding.’ [AR 2023-24 p.27]", "source": "annual-reports/2023-24.pdf", "implementation_steps": [ "Develop simulation models", "Run simulations with different scenarios", "Analyze results and refine models", "Prepare for pilot testing" ], "risks_to_manage": [ "Model inaccuracies", "Resource requirements", "Stakeholder resistance" ] } ], "legislation_administered": [ { "title": "National Health Reform Act 2011", "year": "2011", "type": "Act", "role": "Determine national efficient price and cost for public hospital services and provide aged care pricing advice.", "register_url": "https://www.legislation.gov.au/search?query=National+Health+Reform+Act+2011" }, { "title": "Aged Care Act 1997", "year": "1997", "type": "Act", "role": "Provide aged care pricing advice and approve accommodation deposit amounts and extra service fees.", "register_url": 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