The peak body representing GPs is calling for a major overhaul of the current funding system so that patients can be better supported in the community, and will be less likely to end up in hospital.
The Royal Australian College of GPs’ Frank Jones outlined his plan on Wednesday to federal Health Minister Sussan Ley.
She is also meeting with other medical groups such as the Australian Medical Association to develop potential new funding models after the controversial GP copayment was scrapped.
Under the College of GPs’ plan, doctors would be paid special payments to work in areas of need and be paid extra for managing conditions such as diabetes, mental health, aged and palliative care, preventive health care and immunisation.
Patients would also be offered the chance to enrol at a particular doctors’ surgery, Dr Jones said.
“The model proposes voluntary patient enrolment so that patients can enrol with a specific practice and a preferred GP. This will give patients a medical home and GPs can tailor services to their community,” he said.
If patients take up that offer, GPs would be paid extra to support patients by:
•Establishing stable and enduring relationships with their patients
•Making an overall assessment of their patient’s health (including lifestyle risk factors)
•Creating or strengthening a patient’s record, including family history, collection of medication history, collection of test results from other providers (for example CT scans done at a hospital)
•Initiating interventions or referrals as required
“When the right system is in place to look after people in the community, serious conditions such as heart disease and diabetes can be prevented and the severity of illnesses can also be reduced through improved management,” Dr Jones said.
“This means that fewer people turn up to emergency departments where treatment costs can be more than 10 times those in general practice,” he said.
Fee-for-service model ineffective: report
The Federal Government is considering a number of alternative funding systems for GP care, in particular to help patients with chronic diseases such as diabetes.
A discussion paper from the Government’s national diabetes strategy advisory group suggests scrapping the current ‘fee-for-service’ model, saying it is unlikely to lead to optimal outcomes.
“The fee-for-service model does not incentivise long-term follow up or the proactive care of people with chronic conditions,” it said.
“As such, more innovative funding models are needed that combine fee-for-service reimbursement with other payment types, such as population-based payments and quality-based payments.
“The Government could consider exploring (potentially through demonstration projects) an innovative combination of payment models, such as pooled funds, ‘medical homes’, capitation payments, pay for performance, and pay for quality and outcomes.
“It is also worth considering funding arrangements for allied health professionals.”
A broader review of government Medicare rebates is on the Federal Government’s agenda.
It is likely to include a review of items on the Medicare Benefits Schedule, among other things.
Already, more than 150 items have been identified as inefficient, expensive or ineffective.
The College of GPs is calling for the Government to seriously consider its model and recognise the long-term health savings that can be achieved if it was implemented.
Source: ABC