Billed by the federal government as a “revolutionary reform package”, the Healthier Medicare changes announced on 31 March have the better management of patients with chronic illness firmly in their sights.
The package is also aimed at supporting Aboriginal Medical Services to tackle the growing prevalence of complex chronic conditions amongst Indigenous Australians.
The government has adopted the ‘Health Care Homes’ moniker for the trial program, which was one of the key recommendations of the clinician-led Primary Health Care Advisory Group’s (PHCAG) report Better Outcome for People with Chronic and Complex Conditions.
The Health Care Homes trial with run for two years from 1 July 2017 and will involve 200 practices and 65,000 Australians at a cost of around $21 million.
Noting that the aim is to keep the chronically ill out of hospital, Health Minister Sussan Ley said, “For the first time, Australians living with multiple complex and chronic illnesses will be able to officially enrol with their local GP to have all of their conditions and health care needs conveniently managed in one place.”
She added: “The new model will be supported by a more-flexible payment structure, allowing health practitioners to focus on quality improvement without the rigid constraints of Medicare’s current fee-for-service model.”
The PCHAG recommendation of a ‘bundled’ primary health care payment system will include the introduction of upfront and quarterly bundled payments for GPs who sign up to become Health Care Homes, responsible for co-ordinating care for the chronically ill.
Government figures show that while 1-in-5 people now have multiple chronic conditions, high users of the health system saw an average of five different GPs in a year – triple the rate of low users.
The PHCAG, which is chaired by immediate past AMA President and GP Dr Steve Hambleton, found that, “Most patients with multiple chronic conditions receive treatment from many health providers: most of them working in different locations, and often working in different parts of the health system. This leads to concern regarding the quality and safety of patient care.”
Minister Ley said the establishment of Health Care Homes in General Practices or primary health care services will enable tailored care plans (in consultation with patients) that not only outline the health services they need, but coordinate them as well.
Primary Health Networks will have an important role in supporting Health Care Homes through the establishment and promotion of local clinical health pathways and through education and training support.
The North Coast PHN has strongly supported the Health Care Home model of care in the past and continues to show interest in trialing the model.
