” The Department of Health advises that the payment factsheet on the Health Care Home website has been updated to make it clearer that there is no hard cap on the capability for GPs to bill MBS for services not related to an enrolled patient’s chronic conditions. “
Janet Quigley A/g First Assistant Secretary Health Systems Policy Division email advice to stakeholders 8 November
” The amendment is “a victory for commonsense and for patient health . Anyny move to reintroduce the capped consults in any subsequent rollout of the Health Care Homes initiative would be met with strong concern from health sector stakeholders.
RDAA Vice President, Dr John Hall, welcomed the Government’s amendment.
” Health Care Homes is a major reform of primary health care and aims to reshape the management of chronic and complex conditions by placing patients at the centre of care with general practice and Aboriginal community controlled health services (ACCHS).
The Turnbull Government has allocated over $100m to support the rollout of stage one, which aims to enrol up to 65,000 patients in 200 medical practices in 10 regions across Australia.”
Press Release Sussan Ley last week
NACCHO Aboriginal Health #healthcarehomes
Based on clinical advice, it is expected that for the vast majority of patients the number of fee for service episodes of care will be small, and billing patterns for these services will be monitored in Stage 1 to inform national rollout.
This does not change the existing planning or policy. The expectation is that all general practice health care associated with the patient’s chronic conditions, previously funded through the MBS, will be funded through the bundled payment.
Additional fact sheets will be made available in the coming days.
The Rural Doctors Association of Australia (RDAA) press release
The Rural Doctors Association of Australia (RDAA) has welcomed an amendment made by the Federal Government to its Health Care Homes regime, following concerns expressed by RDAA and other health sector organisations.
A fact sheet originally posted on the Australian Government Department of Health’s website stated that patients with chronic conditions who are registered for chronic care consults under the Health Care Homes trial, would only be allowed a maximum of 5 non-chronic disease related consults under their Health Care Homes arrangement (in addition to their chronic care consults).
But following concerns expressed by RDAA and other groups, including the Royal Australian College of General Practitioners (RACGP), the fact sheet was amended to read:
“Based on clinical advice it is expected that for the vast majority of patients the number of fee-for-service episodes of care, in addition to the bundled payment, will be small. The number of fee-for-service episodes of care will not be capped or restricted, and will be monitored during stage one of Health Care Homes.”
No cap amendments a victory for commonsense and for patient health says our Health Peak groups
RDAA Vice President, Dr John Hall, welcomed the Government’s amendment, calling it “a victory for commonsense and for patient health”.
But he warned that any move to reintroduce the capped consults in any subsequent rollout of the Health Care Homes initiative would be met with strong concern from health sector stakeholders.
“Under the original wording of the regime — which involved capping the number of non-chronic disease related visits under Health Care Home arrangements — chronic care patients unable to afford any further ‘non-chronic’ consults without Medicare assistance would be more likely to present to their local hospital’s Emergency Department for the care they require” he said.
“This would not only have seen patients going to the hospital for health concerns more appropriately and cost-effectively seen in a general practice setting, but it would also have increased the patient load (and pressure) on many hospitals, particularly those in rural and remote settings.
“Given this concern, we have welcomed the Government’s amendments.
“But we remain concerned that the original requirement around non-chronic visits signals that the real intent of the Health Care Homes initiative may not really be about improving patient access to care — it may be more about making budget savings.
“We sincerely hope this is not the case, and we are keen to work with the Government to ensure that improving access to care for patients remains at the centre of this initiative.”