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This report presents the results of phase one of the project to develop Australian Refined Diagnosis Related Groups (AR-DRG)1 Version (V) 8.0. This phase focuses on the case complexity component of the classification that has not been reviewed for many years
The Pricing Framework for Australian Public Hospital Services 2014-2015 builds on the two previous Pricing Frameworks (2012-2013 Pricing Framework and 2013-2014 Pricing Framework). For simplicity, where IHPA reaffirmed a previous principle, the supporting argument was not restated in this paper.
The Independent Hospital Pricing Authority (Pricing Authority) is established under the National Health Reform Act 2011 (Cth) (the Act), and by virtue of section 131(1) of the Act is invested with the following functions relevant to this 2014-15 National Efficient Cost Determination (Determination):
(a) to determine the national efficient cost for health care services provided by public hospitals where the services are block funded;
Governments agreed to establish the Independent Hospital Pricing Authority (the IHPA) to provide independent advice about the efficient cost of public hospital services. Much of this advice will be evidence‐ based, drawing on technical knowledge and expertise about the classification, costing and funding of public hospital services. But, the IHPA must also balance a range of national policy objectives including improving the efficiency and accessibility of public hospital services.
The Independent Hospital Pricing Authority (IHPA) has commissioned the development of a comprehensive Pricing Framework for use in the implementation of activity based funding (ABF) for Australian public hospitals. This report is a short summary of the implementation options, together with selected consultation questions.