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The Pricing Framework for Australian Public Hospital Services 2020-21 (the Pricing Framework) is the key strategic document underpinning the National Efficient Price (NEP) and National Efficient Cost (NEC) Determinations for the financial year 2020-21.
IHPA has issued the Pricing Framework prior to releasing the NEP20 and NEC20 Determinations, which will be publicly available in March 2020, with the intention of providing an additional layer of transparency and accountability.
There is a growing discussion in Australia and internationally about the need to increase focus on delivering value-based health care with a focus on patient outcomes and experience.
IHPA’s Pricing Guidelines and the National Health Reform Agreement include provisions for IHPA to consider the impact on its work of evidence‑based, effective new technologies and innovations in models of health care.
The ICD-10-AM/ACHI/ACS classification system is comprised of the following classifications:
- International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM)
- Australian Classification of Health Interventions (ACHI)
- Australian Coding Standards (ACS)
ICD-10-AM/ACHI/ACS Eleventh Edition is published as a set of five volumes which contain the following products:
As prescribed in Section 225 of the National Health Reform Act 2011, the objectives of the IHPA Work Program are to:
AR-DRG Version 9.0 Final Report
AR-DRG Version 9.0 was approved by the Pricing Authority in November 2016. Development of Version 9.0 was finalised following clinical and statistical analysis and in consultation with clinicians, jurisdictions and other health sector stakeholders. It has been used to price admitted acute episodes of care from 1 July 2018.
The AR-DRG Version 9.0 final report details the changes and rationale for the refinement process.
As prescribed in Section 225 of the National Health Reform Act 2011 (the Act), the objectives of the IHPA Work Program are to:
- set out IHPA’s work program for the coming year; and
- invite interested persons (including states and territories) to make submissions to the Pricing Authority about the work program up to 30 days after publication.
An extract of Section 225 of the Act is attached at Appendix 1
The Pricing Framework 2016-17 builds on the Pricing Frameworks from previous years (2012-13, 2013-14, 2014-15 and 2015-16). For simplicity, where IHPA has reaffirmed a previous principle, the supporting argument has not been restated in this year’s paper.