Workshop Program

Workshop one: Introduction to Activity Based Funding

Presenter: Professor Stephen Duckett, Director of the Health Program at Grattan Institute

Due to popular demand, Professor Stephen Duckett will provide an updated version of last year’s workshop providing a general introduction to Activity Based Funding. A comprehensive explanation of the current national ABF system in Australia, this is a great session for those that are new to the area or a good refresher to keep up to date with the current ABF landscape.

This workshop introduces:

  • The context of ABF
  • Background to casemix measures such as Diagnosis Related Groups (DRGs)
  • How to manage in an ABF environment
  • What to look for if your costs are greater than the ‘efficient price’.

Workshop two: Performance management in an ABF environment

Presenters: John Pilla, Director, Policy, Programmes and Evaluation Practice, KPMG; John O’Connor, Director, Business Health Consulting Services.

This workshop will provide participants with a framework they can use to assess their capacity and capability to optimise performance in an ABF environment. The framework has been used by several hospitals across Australia and is based on the lived experiences of financial, clinical and general administrative executives in public hospitals.

The session will also include two case studies to be delivered by guest speakers; one based on the international experience of Malcolm Lowe-Lauri who is an Executive Director in KPMG and also a senior executive in the NHS where he worked in the payment by results environment (the equivalent to ABF). The second case study will be presented by a senior financial executive from an Australian public tertiary hospital.

The workshop will start with an overview of the critical features of effective performance management and then work systematically through four domains with a focus on specific requirements when operating in an ABF environment. These domains are, budget setting, monitoring and reporting, performance management and governance.

Participants will have the opportunity to discuss challenges and their own experiences and the opportunity to discuss issues with the two guest speakers.

The workshop targets managers and executives who have a responsibility for operational performance and / or who make a key contribution to ABF in their operating environment.

Workshop three: Tying the knot – clinician engagement in ABF

Presenters: Dr Amanda Ling, Deputy CEO, Joondalup Health Campus, Ramsay Health; Philip Hoyle, Director, Medical Services, Royal North Shore Hospital

This workshop explores the substantive “engagement” of the health workforce, with a particular emphasis on clinicians in realising opportunities from Activity Based Funding (ABF).

After a review of the “purpose” of ABF, the generic features of casemix systems will be outlined, with explicit reference to the capacity of such systems to “surface” processes of care production, with resulting clinical, economic and cultural benefits. Simple examples will be used to show, in a mechanistic sense, the workings of the technologies underlying ABF (eg, DRG classification systems), as well as important fallacies.

The session will then discuss the “care process” as the object of study, including a review of research findings on subcultures. Care production constructs will be used to show how ABF interfaces and connects those cultures, with examples of descriptive, analytical and normative ABF information to power engagement both “top down” and “bottom-up”.

The session will also examine broader implications of ABF for a clinically led health system. ABF has changed the relationship between funders and service providers so funders now pay providers to do what is asked. The challenge is to know what to ask for, and in practice this requires a partnership, and refocusing of clinical governance onto what care should be provided where, to what standard and how.

The workshop concludes with strategies for securing ongoing engagement of the workforce in the ABF system. A key theme is making visible and operationalising opportunities for better care, increased autonomy, transparent accountability and a shared vision. These are related back to the original purpose of the National Reforms and the importance of taking this generational opportunity.

Workshop four: The national benchmarking portal

Presenters: Alfa D’Amato, Deputy Director, ABF Taskforce, NSW Health; Rob Anderson, Director, Activity Based Management Reform, WA Health

Activity Based Management (ABM) is fundamental to the New South Wales Health strategic plan which includes the priority of better value care for all. A key tool in making this happen is the national benchmarking portal, created by the Activity Based Funding Taskforce, and designed for use primarily by clinicians.

This workshop provides an overview of the national benchmarking portal which offers ‘insights’ as well as data, as the data can be interpreted, compared and benchmarked. At the click of a portal button, clinicians and nominated staff have fast and easy access to high level data to support or inform local decisions to improve patient care.

Learn how the national benchmarking portal can:

  • Look at phase of care
  • Provide a detailed view of frequent patients to examine their history, treatment and costs
  • Find local instances of clinical variation
  • Compare performance against the benchmarked aggregate costs of other LHDs/SHNs state-wide.

Workshop five: Realising the potential of the National Efficient Price (NEP)

Presenters: Dr Sarah Neville, Director Pricing, IHPA; Dr Trent Yeend, Senior Advisor, Pricing & Funding, IHPA; Sean Heng, Mathematical/Statistical Analyst, IHPA.

The National Efficient Price (NEP) 2016-17 is the fifth annual determination for Activity Based Funding (ABF) of Australian public hospital services. The NEP underpins the implementation of a nationally consistent ABF system and is used in the calculation of the Commonwealth Government’s payments to Local Hospital Networks (LHN) funded on an activity basis.

To determine the NEP, IHPA develops cost and pricing models that explain the expenditure of Local Hospital Networks nationally, while applying the policies contained within the Pricing Framework for Australian Public Hospital Services. These models are based on an extensive range of data sources that detail the costs and many other characteristics of Australian public hospital services.

This workshop will provide an overview of the role of the NEP in the funding of public hospital services and detail its application through the combined use of the NEP, price weights and adjustments. The session will also explore the derivation of the NEP, including uses of the many underlying sources of data.

The workshop will be structured to engage the audience in discussion throughout, drawing upon experience and knowledge to enhance perspectives and understanding of the NEP and ABF.

Workshop six: Clinical costing

Presenters: Stathi Tsangaris, Director Hospital Costing, IHPA; Myles Cover, Technical Manager, Hospital Costing, IHPA; Michael Rabenschlag, Director Department of Economics, Institute for the Hospital Financing System, InEK GmbH; Dr Prabhu Sivabalan, Associate Professor, Management Accounting, UTS Business School; Phillip Battista, Senior Manager, Funding Models Finance and Corporate Services, SA Health.

The National Hospital Cost Data Collection (NHCDC) is an annual collection of patient level cost data from public hospitals in Australia. Currently, its primary use is the determination of the National Efficient Price (NEP), leaving the detailed cost object and account code data as a comparatively untapped resource.

This workshop will provide an overview of the data available in the NHCDC and its potential uses. The first half of the session will provide insight into the types of data that comprises the NHCDC and how it can potentially be used to identify costing challenges, such as cost completeness and variation between streams and jurisdictions.

The second half of the session will involve a panel discussion on costing challenges and questions will be open to the floor. The panel will contain jurisdictional and hospital level costing experts and aims to promote transparent discussion between stakeholders on the difficulties faced in hospital costing.