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Government announces revolution for general practice Paul Smith

| 31 March, 2016 |

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Up to 200 GP clinics will pilot the Federal Government’s plan to revolutionise the care of some

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seven million patients with chronic diseases. Health Minister Sussan Ley (pictured with RACGP president Dr Frank Jones) says she has created 'Health Care Homes' to “co-ordinate all of the medical, allied health and out-of-hospital services” as part of a patient’s tailored care plan. Patients eligible for these care plans will have to register with practices under a patient enrolment scheme. Under the reforms announced on Thursday, these patients will then be stratified into three separate tiers, likely to be based in part on their risk of hospitalisation. Each patient tier will then access a range of services — both within and outside the practice — to meet their needs.

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Related News: • Patient enrolment centrepiece of reform plan • Govt launches discussion on future of general practice Called Healthier Medicare, the package is being touted by Prime Minister Malcolm Turnbull as one of the largest health system reforms in 30 years.

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The RACGP, a long-time advocate of voluntary patient registration and medical homes, hailed the plan as “life-saving”. However, there are still large holes in what the government is promising. On funding for the Health Care Homes, the government said payments would be “bundled together into regular quarterly payments”. It is expected that the “proof of concept trial”, which involves 200 practices and some 65,000 patients, will begin next year. As yet, there are no details on how much money will be on offer or how the plan fits with current MBS chronic disease items.

http://www.australiandoctor.com.au/news/latest-news/government-announces-revolutio... 1/04/2016

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There are no details about the eligibility or assessment of patients who will get care packages, no detail on the care packages themselves or the services available, and there are no details about whether Health Care Homes are expected to become effective fund-holders, required to commission services for their patients. The government’s pledge to transform general practice has been drawn up in response to a string of recommendations from the Primary Health Care Advisory Group (PHCAG). The group's executive summary Better outcomes for poeple with chronic and complex health conditions was released on Thursday, but has little detail on how the new care model for chronic disease will work. On funding, the advisory group's report says “existing payment systems” should be “redesigned”. “These should include the introduction of bundled payments, block payments and pooled funding to support the new approach, while preserving fee-for-service for episodic care.

“Consider the range of MBS items and other Commonwealth funding programs that could be brought together to support a more targeted and flexible approach to funding.” Again there is no mention of the amount of money required to make the reforms work. The advisory group paper also suggests a great role for primary health networks to commission services that would support the care packages devised by the Health Care Homes. Ms Ley said that a Health Care Home "implementation advisory group” will be set up to oversee the “design, implementation and evaluation of the trials ahead of the national rollout”. The RACGP welcomed the reform plan, saying it “congratulated” the government for “taking the RACGP’s advice onboard and tackling the growing burden of chronic disease”. President Dr Frank Jones added: “As the academic college for general practice, it is vital the RACGP is involved in the stratification of pilot practices, to ensure we get a representative mix.” Advertisement

The government's media release said its primary health care reforms will consist of: • Tailored patient care plans developed in partnership with patients and their families. • The establishment of ‘Health Care Homes’, which will co-ordinate all of the medical, allied health and out-of-hospital services required as part of a patient’s tailored care plan. • Health Care Homes will be delivered by GP clinics or Aboriginal Medical Services. Patients will be able to enrol with the home of their choice. • Payments for Health Care Homes will be bundled together into regular quarterly payments to encourage providers to be flexible and innovative in how they communicate and deliver care.

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• This signals a move away from the current fee-for-service model for these eligible patients, except where a routine health issue does not relate to their chronic illness.

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• Improved use of digital health measures to improve patient access and efficiency, including the new MyHealth Record, telehealth and teleweb services, remote health monitoring and medication management technologies.

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• A risk stratification tool to determine an individual patient’s eligibility for the new packages.

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• Stronger data collection, measurement and evaluation tools to allow a patient’s individual progress to be measured and their care plan to be better tailored to their needs.

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More information PHCAG Report: Better outcomes for poeple with chronic and complex health conditions

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