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.
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.