Health Care Home for sale?

The government seems to have lost the goodwill of the profession about their Health Care Homes model. On Friday afternoon the details of implementation stage 1 were published and it was underwhelming – to say the least.

A health reform like this, which should focus on better integration, coordination and team care, must be planned and rolled out in collaboration with the profession and consumers, not quietly published on a Friday afternoon.

Despite initial reassurances from Federal Health Minister Sussan Ley, there has been no consultation. Many GPs have expressed concerns during the weekend or indicated that they have lost interest in the model.

Restricted Medicare access

The government’s Health Care Homes model does not reflect the RACGP’s best practice model of the medical home, as outlined in the RACGP Vision for general practice and a sustainable healthcare system, released in September 2015.

Several details of the government’s proposed model, including the risk stratification tool, are not yet available. What happened to support for multidisciplinary team care, comprehensiveness loading (incl for rural and remote areas) and realigning PIP and SIP funding?

Under the model support payments for chronic disease management will be bundled, with enrolled patients eligible for only 5 non-chronic disease related services per year. Restricting access to acute care for people with chronic and complex conditions is not helpful and puts patients at risk.

Underfunded trial 

RACGP president Bastian Seidel said: “At best, it is a two year underfunded trial on the effects of inadequate capitation funding. It will put financially vulnerable patients at risk of not having access to Medicare rebates when they seek care that is not associated with their predetermined chronic health condition.”

It is difficult to comprehend that the government acknowledges there is a growing problem with regards to Australians living with chronic & complex conditions, it wants major reform to tackle this issue but is not prepared to invest in a sustainable, evidence-based and cost-saving model supported by the profession and consumers – and does not consult.

The proposed model is inadequately funded and will likely fail to improve health outcomes for Australians living with chronic and complex health conditions. I’m sure the government can do better than this.

Our story, our vision – the future of general practice

We now have an excellent vision for a sustainable Australian healthcare system and general practice.

The final version of the vision was released by RACGP president Dr Frank Jones at the GP15 conference in Melbourne this week. It is based on feedback from over 1,000 GPs, stakeholders and consumer groups.

There are 2 elements of the vision that make it remarkable:

#1: the medical home

A stable and enduring relationship between a patient and a GP has a positive impact on health outcomes. The medical home encourages voluntary patient registration with a preferred practice. It will benefit patients and doctors as it allows for continuity of care and effective, better-targeted coordination of care to meet patient needs.

Patients may choose whether to enrol with a practice of their choice. Likewise, GPs and practices may choose to take part in the program.

Patients will be able to visit any general practice for standard care, but chronic disease management, integration of care and preventive health will be limited to their medical home.

#2: a new funding model

The RACGP proposes a major overhaul of the current funding system. It’s a flexible model and includes support for GPs and their teams to deliver multidisciplinary teamwork and coordination work on behalf of their patients.

A comprehensiveness payment made to a practice would recognise the practices and practitioners that provide a broad range of services to the community.

The current PIP and SIP regimes need to be replaced by practitioner support and practice support payments as outlined in detail in the vision document.

The story of general practice is told in this new RACGP video, spoken by Sigrid Thornton.