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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 .

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Queens Health Policy Change Conference Series Australian Health Reform Progress

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Queens Health Policy Change Conference SeriesAustralian Health Reform Progress

Prof Mick Reid

May 2014


Health/Hospital Boards

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.


Primary Health Care

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.

-Under review.


Transparency/Performance

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.


Transparency/Pricing

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.


E-Health

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’).


Safety and Quality

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 Progress

Uncertainties

-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

-Federal Budget.


Commission of Audit Proposals

-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.


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