Queens Health Policy Change Conference Series Australian Health Reform Progress. Prof Mick Reid May 2014. Health /Hospital Boards. Most States have created District Hospital Boards -Devolved authority from State Authorities. - I ncreased local autonomy .
Queens Health Policy Change Conference SeriesAustralian Health Reform Progress
Prof Mick Reid
Most States have created District Hospital Boards
-Devolved authority from State Authorities.
-Increased local autonomy.
-Improved clinical engagement.
-Fostered local innovation e.g. Workforce.
-Adopted transparent funding arrangements.
-Greater public/private interaction to provide public services.
Federal Government has created 61 ‘Medicare Locals’ throughout Australia – GP and other community health personnel.
-In some States boundaries of Medicare Locals equate District Hospital Boards.
-Joint Planning now enabled.
-Some contracts evolved between DHBs and MLs re hospital avoidance/frequent flyers.
-Still too early to judge overall effectiveness.
National Health Performance Authority
-Role to monitor and report on performance of public and private hospitals and Medicare Locals.
-Reporting scope determined by Federal/State Health Ministers.
-This year will publish first ‘poor performance’ report.
-Complements actions of States in managing/monitoring performance of their hospitals.
Independent Hospital Pricing Authority
-Role is to calculate an annual National Efficient Price.
-NEP determines Commonwealth funding contribution to hospitals according to hospital activity levels or block funding (for smaller hospitals).
-In all States, public hospitals paid for number/mix of patients they treat.
-Pricing extended from inpatient to outpatient clinics, community based clinics and inpatients homes (HITH).
-Creates $ incentives for hospital avoidance, early discharge.
-Greater pressure on hospitals as ‘efficient price’ more rigorously enforced.
National E-Health Transition Authority (NEHTA) owned by Federal/State governments.
-Role is to develop foundations/services for national e-health capability.
-Particular emphasis on creation of Personally Controlled Electronic Health Record. Designed for consumers to share health information with different providers.
-Commenced 1/7/2012. An opt in system
-1.5 million Australians have joined
-strong collaboration with vendors re specs/standards
-not a replacement for local clinical information systems.
Currently under review (opt in to opt out/greater private ‘ownership’).
Australian Commission of Safety and Quality in Health Care
-Coordinates national improvements in safety and quality.
-Focus on clinical communications/falls prevention/health associated infection/medication safety/open disclosure/accreditation standards/patient experience.
-Health Reform initiated prior to change to conservative governments Federally and in most States.
-New governments concerned with achieving balanced budgets/decreasing government outlays.
-Status of Commission of Audit Report
-Universal access to bulk billing (i.e. free to consumer)
GP services abolished.
-$5–$15 copayment on GP attendances.
-Increased copayment for pharmaceuticals.
-Enforcing private health insurance for high income earners.
-Introduce copayment for ‘GP like’ attendances at emergency departments.
-Recommends merging of a number of national health agencies on pricing, performance, quality and data collection, abolishes others.
-Allow pharmacists/nurses to take broader role.