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The goal of the Consultation and review of the AR-DRG and ICD-10-AM/ACHI/ACS Classification Systems report was to review the end-to-end development processes, implementation arrangements and user needs in developing and implementing updates to the following classifications, now and into the future:
The Independent Hospital Pricing Authority (IHPA) is established under the National Health Reform Act 2011 (Cwlth) (the Act), and by virtue of section 131(1) of the Act is invested with the following functions relevant to this National Efficient Cost Determination 2020–21 (Determination):
ICD-10-AM/ACHI/ACS Eighth Edition was implemented between 1 July 2013 and 30 June 2015 for classifying episodes of admitted patient care across Australian hospital services.
The ICD-10-AM/ACHI/ACS classification system is comprised of the following classifications:
The Australian Refined Diagnosis Related Group (AR-DRG) Version 7.0 was implemented from July 1, 2014 and is the Australian Diagnosis Related Group (DRG) patient classification system that provides a clinically meaningful way of relating the types of patients treated in the hospital to the resources required by the hospital. AR-DRGs incorporate the ICD-10-AM/ACHI/ACS.
The AR-DRG Version 7.0 is published as a set of three Definition Manuals described below.
In June 2012, the Independent Hospital Pricing Authority (IHPA) published the National Efficient Price Determination for 2012-13, and the Pricing Framework for Australian Public Hospital Services 2012- 2013 that underpinned the determination. In September 2012, IHPA released a consultation paper on key issues that IHPA was considering in the preparation of the Pricing Framework for Australian Public Hospital Services 2013-2014.
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 National Efficient Cost Determination 2013 (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.