Document ID: chunk:federal_register_of_legislation:F2017L00179:schedule:4:p2
Version: federal_register_of_legislation:F2017L00179
Segment Type: schedule
Provision Reference: sch 4 (pt 2/4)
Character Range: 3696–6924

readmissions, based on a set of definitions to be developed by the Australian Commission on Safety and Quality in Health Care.

  2.      Matters the Independent Hospital Pricing Authority is to have regard to

    (i)                 In performing the activity referred to in Item 1(i)(a), the Independent Hospital Pricing Authority must have regard to the intention of COAG Health Council to:

       (a)   implement an adjusted funding model for sentinel events from 1 July 2017;

       (b)   have regard to the Australian Commission on Safety and Quality in Health Care's review of sentinel events; and

       (c)   monitor and review the reporting of sentinel events by States and Territories to ensure those events are adequately reported for the purpose of funding adjustments.

(ii)               In performing the activity referred to in Item 1(i)(b), the Independent Hospital Pricing Authority must have regard to the intention of COAG Health Council to:

       (a)     further refine the risk adjustment methodology for the COAG Health Council agreed hospital acquired complication model prior to 1 July 2017;

       (b)     shadow the implementation of the hospital acquired complication model to assess impact on funding, data reporting (e.g. condition onset flags), clinical information systems, and specific population and peer hospital groups; and

       (c)     public consultation on the findings of the shadow implementation with a final report submitted to COAG Health Council by 30 November 2017;

       (d)     provide direction and monitoring of State and Territory programs to audit medical records and coding to support continued improvement in reporting of hospital acquired complications; and

       (e)     implementation of reduced funding levels for all hospital acquired complications, subject to the results of the shadow period, from 1 July 2018.

(iii)            In performing the activity referred to in Item 1(i)(c), the Independent Hospital Pricing Authority must have regard the intention of COAG Health Council for:

        (a)     the Australian Commission on Safety and Quality in Health Care to develop a list of clinical conditions that can be considered avoidable hospital readmissions, including identifying suitable condition-specific timeframes for each of the identified conditions;

        (b)     the Independent Hospital Pricing Authority to provide additional advice on feasibility and financial implications of  potential future pricing or funding adjustments for avoidable readmissions in accordance with the list of clinical conditions; and

        (c)     the development of pricing or funding adjustments to target avoidable hospital readmissions which arise from complications of the management of the original condition that was the reason for the patients original hospital stay.

(iv)             The Independent Hospital Pricing Authority's inclusion of the options referred to in Item 1 of this Direction in The Pricing Framework for Australian Public Hospital Services, in March 2017.

    (v)               In undertaking implementation, evaluation and provision of the advice described in Item 1 of this Schedule, the Independent Hospital Pricing