Document ID: chunk:federal_register_of_legislation:F2016L01377:schedule:4:p1
Version: federal_register_of_legislation:F2016L01377
Segment Type: schedule
Provision Reference: sch 4 (pt 1/3)
Character Range: 798–3965

Schedule    4

Part 1 Preliminary

         1.                    Name of Direction

This Instrument is the Direction to the Independent Hospital Pricing Authority on the performance of its functions under section 226 of the National Health Reform Act 2011 - No. 1/2016.

     2.                      Commencement

This Direction takes effect on the day after it is registered on the Federal Register of Legislative Instruments.

     3.                      Authority

     This Direction is made under subsection 226(1) of the National Health Reform Act 2011.

     4.                      Definition

     In this Direction:

     Act means the National Health Reform Act 2011.

     hospital acquired condition means a hospital acquired patient complication, as defined by the Australian Commission on Safety and Quality in Health Care, for which clinical risk mitigation strategies may reduce (but not necessarily eliminate) the risk of that complication occurring.

     avoidable hospital readmission means readmission to hospital within 28 days of discharge, with a particular focus on avoidable readmission within 5 days of discharge, for a condition or conditions arising from complications of the management of the original condition.

     sentinel event means one of a subset of adverse events that result in death or serious harm to a patient.

     5.                      Schedule

The Schedule to this Instrument describes the direction given to the Independent Hospital Pricing Authority on the performance of its functions.

Schedule

   1. Functions

(i)                 The Independent Hospital Pricing Authority, in relation to its functions under paragraphs 131(1)(a) and (h) of the Act must advise the Commonwealth, the States and the Territories (the Parties) on an option or options for:

       (a)   a comprehensive and risk-adjusted model to determine how funding and pricing can be used to improve patient outcomes and reduce the amount the Commonwealth pays for sentinel events, and a set of preventable hospital acquired conditions, defined by the Australian Commission on Safety and Quality in Health Care and agreed by the Parties, that occur in public hospitals; and

       (b)   a comprehensive and risk-adjusted strategy and funding model to reduce avoidable readmissions to hospital that will adjust the funding to hospitals that exceed a predetermined avoidable readmission rate for an agreed set of conditions and the circumstances in which they occur.

    (ii)               In performing the activity referred to in Item 1(i)(a), the Independent Hospital Pricing Authority must have regard to the Parties' intention to:

       (a)   implement a model for sentinel events from 1 July 2017; and

       (b)   implement a model for an agreed set of preventable hospital acquired conditions not before 1 July 2018, with a preceding shadow year.

(iii)            In performing the activity referred to in Item 1(i)(b), the Independent Hospital Pricing Authority must have regard to the Parties' intention to focus on avoidable hospital readmissions within 5 days of discharge for conditions referred to in Item 1(i)(b) arising