Abstract
In 2011 the Council on Australian Governments (COAG), via the National Health Reform Agreement, introduced changes to hospital funding, some of which have potentially serious implications for people with a mental illness or disorder. Of particular concern is the introduction of Activity Based Funding (ABF), which ties funding to listed services provided, rather than programs or bundles of services. The RANZCP has kept a close watch on these developments leading up to the introduction of ABF for mental health services, which is planned for 2014.
Specifically, the College is concerned that the current ABF algorithms cannot adequately capture the complexities of interactions, which often occur in multiple settings that include community-based or ‘non-admitted’ services. What the government policy-makers need to understand is that measuring mental recovery is more complex than measuring physical healing.
The organisation set up to develop the funding framework is the Independent Hospital Pricing Authority (IHPA). It has held several public consultations and recently, it released a consultation paper, Pricing Framework for Australian Public Hospital Services 2014 – 2015. This Framework still excludes important community mental health services, including specialist early intervention services, child and adolescent mental health services, and the older persons’ community mental health services. The College maintains that it is essential that all public mental health care settings are included in the ABF classification system, and refutes the IHPA’s claim that admission rates for these settings are low.
In early August 2013, the College met with the IHPA to advocate the inclusion of these services in ABF listings, on the basis that rates of admission within these services are often significant. For example, data from the Australian Mental Health Outcomes and Classification Network from 2009 – 2012 showed that there were 45,331 national ambulatory admissions in child and adolescent mental health care, during that time.
As a general principle, the College does not support the implementation of ABF in mental health service until valid funding and classification systems are developed and demonstrated to be effective for each mental health care setting; however, it appears that ABF will be the primary source of Commonwealth funding for public hospital services in the future, and as such, the College believes that all mental health services should be within scope, to ensure adequate Commonwealth funding. The College will continue to seek further information from the IHPA on these issues and advocate for a system that provides high quality, equitable services for people with mental illness.
The College’s submissions to the IHPA can be found on the website: http://www.ranzcp.org/Publications/Submissions-and-Reports.aspx