Australian Doctor Australian Doctor 28th July 2017

28 JULY 2017
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Trial and error
Fears remain over Health Care Homes
GEIR O’ROURKE
THE biggest reform to general
practice in a generation seems to be
wobbling, as practices bail out of
the Health Care Homes trial.
Last week, 200 practices should
have signed formal contracts with
the Federal Government to take
part in the reforms, which spell the
end of MBS fee-for-service pay-
ments to treat patients with chronic
disease.
Under the reform, the practices
will receive annual capitation pay-
ments of up to $1800 for each
patient they register instead.
But the biggest GP corporate in
Australia is refusing to put pen to
paper, saying the legal and account-
ing implications of the new funding
model remain unclear.
Several other practices have
dropped out altogether, forcing the
Department of Health to draw up a
reserve list, as well as extending the
contract deadline to 31 July.
IPN CEO Dr Ged Foley has yet to formally sign up to the Health Care Homes
trial, saying the implications of the new funding model are unclear.
IPN, which has 47 practices in
the trial, says it needs more time
before signing the contracts so it
can solicit independent legal advice.
“We are not going to commit
our practices without full consul-
tation from the GPs within them,”
says CEO Dr Ged Foley.
Under the model, capitation
funds are paid directly to practices,
which will then pay GPs. However,
most practices currently operate as
service providers for — rather than
an employer of –— GPs. Despite
health department reassurances,
many practices fear the shift will
wreak havoc with their tax status.
Practices are also concerned
about the indemnity issues, with
questions about their liability if one
of their GPs faces legal action.
“The timelines we have been
given by the department are incred-
ibly tight and the tax and indemnity
issues still need to be addressed,”
Dr Foley says.
Many practices Australian Doc-
tor spoke with said they were still
enthusiastic about the clinical
freedoms the new funding model
offered, mainly because doctors
and practice staff would no longer
be restricted by the dictates of the
cont’d page 8
Patients urged to shop for specialists
RACHEL WORSLEY
PATIENTS will be encouraged
to shop around for a different
specialist to the one named in their
GP referral, under a push to boost
healthcare competition.
The idea — strongly condemned
by the RACGP — is one of several
presented in a draft Productivity
Commission report exploring
ways to inject greater user choice
by weakening existing referral
AD_ F CB_ i 1 0 _ h r
-
networks.
The report says patients
should be given greater scope to
“independently choose” a public
outpatient clinic or private specialist
“after leaving the GP’s office”.
“This would give patients
the opportunity to do their own
research, consider their options,
and perhaps consult family and
friends before making a decision.”
Under the Health Insurance
Regulations 1975, which details the
1 conditions
2 0 1 6 under
- 1 0 which
- 2 0 specialist
T1 1 : 4 6 :
referrals qualify for Medicare
payments, GPs are not required to
name a particular clinic or specialist
on a referral.
The rules also allow any doctor in
the relevant speciality to accept a
referral, regardless of whether they
are named on the referral.
The commission claims these
rules are poorly understood by
doctors, and should be amended
to clarify that patients can choose
2 8 +
1 1 private
: 0 0 specialist after
their
own
receiving a referral and advice from
their GP.
“This could increase competition
among private specialists, by
reducing the importance of
established referral networks,” the
draft report states.
“There are risks to greater
choice, but their likelihood is low.”
But the RACGP is not happy
about the proposal.
“Completely removing the ability
See page 30
for your chance
to win.
cont’d page 8
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