Table 3.

Technical agencies established for hospital price setting

Setting	Entity	Responsibilities	Scope of Data Collection for Costing	Resources
Australia	Independent Hospital Pricing Authority (IHPA)	The IHPA is responsible for activity‐based costing, the classification system (AR‐DRGs and for subacute and nonacute services in the Australian National Sub‐acute and Non‐Acute Patient Classification), data collection on activity (the National Hospital Data Collection), calculating costs (with a standard framework for costing activities, ie, the Australian Hospital Patient Costing Standards).	Data collection covers inpatient care, subacute, emergency, and outpatient services. All public hospitals participate every 1 to 2 years. A separate system of data collection is undertaken from 91 (out of 630) private hospitals on a voluntary basis.	For the financial year 2017/2018, the IHPA's total expenses were AUS $17.9 million (US$ 23.4 million), and 42 staff were employed.
France	Technical Agency for Hospital Information (ATIH)	The ATIH is an independent public administrative institution cofunded by the government and national health insurance funds, under the control of the Social and Finance Ministries. It collects data and categorizes diagnosis‐related groups (DRGs).	Data collection covers acute inpatient and outpatient care excluding psychiatric services, emergency care, and rehabilitation. Some 135 hospitals participate on a voluntary basis annually.	For the financial year 2017, the ATIH employed 118 staff, and its expenses amounted to EUR 29.4 million (US$ 24.9 million).
Germany	Institute for the Hospital Remuneration System (INEK)	The INEK is jointly supported by the Federal Association of Sickness Funds, the Association of Private Health Insurance, and the German Hospital Federation. It receives data from hospitals annually to develop the Case Fee Catalogue for the following year. Hospital data follow a standardized cost accounting approach to calculate the costs of treating individual patients. Participating hospitals receive a fixed allowance for sharing the cost accounting data.	Data are collected about medical treatment, nursing care, pharmaceuticals and therapeutic devices, board and accommodation, and excluding intensive and emergency care. Some 300 hospitals participate on a voluntary basis annually.	All hospitals pay a diagnosis related group (DRG) system contribution per hospital case, and the InEK receives one‐third of the total contribution to fund their activities. In 2017, the INEK's estimated budget was EUR 8.2 million (US$7.3 million). It employs approximately 50 staff.
Maryland, USA	Health Services Cost Review Commission (HSCRC)	The HSCRC establishes hospital rates to promote cost containment, access to care, equity, financial stability, and hospital accountability. All Maryland hospitals are paid based on the rates established by the HSCRC. These rates are updated each year based on multiple factors, including the Medicare “market basket” forecast, economic conditions, productivity improvements, changes in case mix, and the previous year's performance.	Data include inpatient and outpatient services among participating providers collected annually.	The HSCRC employs 39 full‐time staff, with a budget of US$14.1 million funded by fees collected from hospitals.

Source: 12.