9. Casemix Formula

The basic casemix funding formula will continue during 1998 - 99.

9.1 Variable Payments

9.1.1 Inpatients

Unit DRG Payment

For hospital throughput up to the level prescribed by Target A, the variable case payment per patient treated is $1,368 per WIES6. Private patients will be paid at $968 per WIES6.

Target A Margin will be paid at $958 per WIES6.

Option WIES will be paid at $1,368 per public WIES6.

Same day medical targets for specified DRGs have been defined for each hospital and same day medical throughput in excess of these targets will not be funded.

Rural/Isolated Payment

The rural and isolated hospitals payments will be $14 and $35 per WIES6 respectively, and will apply to those hospitals designated in the Funding Guidelines.

Nursing Home Type Payment

Nursing home type patients in acute hospitals will be funded at $125 per day.

Rehabilitation in Designated Units

Rehabilitation in designated units will be funded at $345 and $287 per day.

9.1.2 Non-Admitted Patients

VACS Variable Grant (Group A hospitals)

For non-admitted throughput up to target the case payment will be $104 per weighted encounter. Targets have been set at 1997 - 98 activity levels. Case payments have been calculated for the year as shown in the modelled budgets and will be paid on a quarterly basis. Case payments will only be paid for public encounters and, where activity varies significantly from the agreed profile of services, or fails to reach target, adjustments will be made.

9.2 Other Grants

9.2.1 Inpatients

Notional Fixed Grant

Notional fixed grants have been standardised and reflect differences in infrastructure costs. The rates for grant are $829 per fixed WIES for Major Providers (i.e. Networks and Barwon Health), $843 for large rural Group B hospitals, $864 for smaller rural Group B and C hospitals, and $887 for rural Group D and E hospitals. The notional fixed grants are then adjusted for historic differences in superannuation costs. For details on the calculation of notional fixed WIES refer to Section C: Calculation of WIES.

Training and Development Grant

These grants will continue for 1998 - 99 with the exception of grants for Salaried Medical Officers. The rates are detailed below:

Hospital Medical Officers Year 1, 2 and 3 Accredited Registrars Clinical Academic Staff Grade 1 Registered Nurses Post-graduate Nurses Post-graduate Midwifery Nurses Pharmacy Trainees Medical Radiation Interns Medical Biophysics Trainees Physiotherapists Grade 1, Year 2 Occupational Therapists Grade 1, Year 2 Speech Pathologists Grade 1, Year 2 Medical Laboratory Scientists

$34,209 per EFT $35,634 per EFT $39,594 per EFT $12,424 per EFT $11,388 per EFT $ 9,835 per EFT $24,306 per EFT $24,080 per EFT $13,631 per EFT $14,197 per EFT $14,197 per EFT $14,197 per EFT $11,531 per EFT

Payments are made only for positions and staffing approved or otherwise recognised by the Department. Detailed definitions of the payment conditions for Training and Development Grants are included in the Funding Guidelines. In addition, there is an undergraduate allowance calculated as 10 per cent of the total training and development grant for Group A and B hospitals. Research grants will continue at the rates of $1,443,805 and $481,268.

Specified Grants

Approved specified grants will continue in 1998 - 99.

9.2.2 Non-Admitted Patients

Emergency Services Grant

The non-admitted Emergency Services Grant will be allocated separately to account for emergency services. The levels of funding are outlined in Table 6.

Base Grant

In 1998 - 99, the Base Grant will continue at the same level as 1997 - 98.

Teaching Grant

In recognition of the importance of non-admitted services for teaching and training a specified grant will continue to be allocated as a teaching grant. In 1998 - 99, the Teaching Grant will continue at the same level as 1997 - 98.

Allied Health Services Grant

This grant will be determined on the basis of allied health occasions of service as reported by hospitals to the Department at an average cost of $38 per occasion of service.

Other Grants

These include services approved by the Clinical Panel for specific funding. The outpatient component of the NESB Grant has been transferred to the inpatient specified grant.

9.3 Enhancement Programs

The Hospital Access Program replaces the Emergency Services Enhancement Program and the Elective Surgery Enhancement Program. Criteria for receiving the payments are outlined in Appendix 3.