Consultation Paper on the Pricing Framework for Australian Public Hospital Services 2026–27

Closed 13 Jun 2025

Opened 14 May 2025

Contact

02 8215 1100

submissions.ihacpa@ihacpa.gov.au

Feedback updated 3 Dec 2025

We asked

From 14 May to 13 June 2025, we held our public consultation on the Pricing Framework for Australian Public Hospital Services 2026–27.

You said

We received 30 submissions from a wide range of stakeholders. This included state and territory governments, professional health organisations and the private health sector.

The consultation covered several key areas, including:

  • pricing admitted acute care using Australian Refined Diagnosis Related Groups Version 12.0 for the National Efficient Price Determination 2026–27 (NEP26)
  • refining the Tier 2 Non-Admitted Services Classification for NEP26 and introducing Tier 2 classes for hospital based non-admitted voluntary assisted dying services
  • phasing out the coronavirus disease 2019 temporary measures for NEP26
  • reviewing the block funding criteria that underpin the national efficient cost determination and the current approach for funding high cost, highly specialised therapies
  • refining pricing adjustments, including for intensive care unit patients, First Nations peoples, and individuals residing in smaller jurisdictions or rural and remote areas of Australia
  • exploring risk factors for inclusion in the hospital acquired complications and avoidable hospital readmissions risk adjustment models.

We did

We have released the Pricing Framework for Australian Public Hospital Services 2026–27 following public consultation.

The pricing framework is accompanied by the consultation report, which captures a summary of feedback received and IHACPA’s response.

Published responses

View submitted responses where consent has been given to publish the response.

Overview

IHACPA has released its Consultation Paper on the Pricing Framework for Australian Public Hospital Services 2026–27.

The aim of this consultation is to seek feedback on our approach to developing the activity based funding system and block funding arrangements for Australian public hospital services.

The pricing framework for Australian public hospital services is revised and published each year. It outlines the policies that underpin the national efficient price and national efficient cost determinations for the next financial year.

These determinations play a crucial role in calculating the Australian Government funding contribution to public hospitals.

IHACPA invites all interested parties to provide feedback.

Feedback will inform the development of the pricing framework.

This year’s consultation paper focuses on:

  • pricing admitted acute care using Australian Refined Diagnosis Related Groups Version 12.0
  • reviewing the block funding criteria that underpin the national efficient cost determination
  • reviewing pricing adjustments, including for intensive care unit patients, First Nations peoples and individuals residing in rural and remote areas of Australia
  • reviewing risk factors for inclusion in the hospital acquired complications and avoidable hospital readmissions risk adjustment models.

Read the consultation paper.

What happens next

Submissions for this consultation close 5pm AEST Friday 13 June 2025.

The feedback and comments from this consultation will be incorporated into the Pricing Framework for Australian Public Hospital Services 2026–27.

The pricing framework will be released in December 2025. It will take effect from 1 July 2026.

Ways to make a submission

  • submit your response online
  • email submissions.ihacpa@ihacpa.gov.au
  • post to Independent Health and Aged Care Pricing Authority, PO Box 483, Darlinghurst NSW 1300

Submissions to the consultation paper

Please note: Unless you specifically request that your submission or parts of your submission should not be released, all submissions will be published. We retain the right not to publish any submissions, or part thereof, where we consider it appropriate to do so.

Personal contact details for all submissions will be removed or redacted from each submission before they are published on our website. Your information will be stored securely and used in accordance with IHACPA’s Privacy Policy.

What happens next

The feedback and comments from this consultation will be incorporated into the Pricing Framework for Australian Public Hospital Services 2026–27.

The pricing framework will be released in December 2025. It will take effect from 1 July 2026.

Audiences

  • Academic
  • Health professional/clinician work for a Local Health Network (LHN) or public hospital
  • Health professional/clinician work for a Primary Health Network (PHN)

Interests

  • Pricing Framework for Australian Public Hospital Services