23 August 2017

Health Care Homes tax issue resolved

Chronic Disease Government

IPN has reconfirmed its commitment to the commonwealth’s Health Care Homes trial after resolving questions about tax liabilities, with more than 30 of its practices set to take part.

Questions about whether a proposed system of making bundled payments to practices would create a payroll-tax headache threw preparations for the chronic-disease management trial into limbo.

Stage one of the trial, involving 20 practices and Aboriginal health services in the western Sydney and north-western Melbourne PHN areas, is due to start in October.

In a statement, Dr Gerard Foley, CEO of Sonic Clinical Services, emphasised IPN’s support for the trial to explore “innovative new approaches to chronic disease management”.

“Our assessment is that the fundamental principles behind the HCH model are sound and point towards contemporary best practice,” he said.

IPN, the primary-care division of Sonic Healthcare, had taken advice that the tax status of its doctors as consultants would not be affected by the bundled-payment model, resolving the payroll tax issue, a spokeswoman said.

IPN now has 31 medical centres lined up to become Health Care Homes. The number is down from 47 IPN practices in the shortlist of 200 announced by the Department of Health.

“On a closer look, some were very small and not suited,” Sonic Clinical Services communications general manager, Julie Toma, said.

It was critical to get the formula right, and IPN had many doctors who were “very positive and passionate” about the trial, she said.

In its latest update, the Health Department said it had signed up only 103 of the intended 200 practices, as of August 7.

It said 27 of the 200 shortlisted practices had withdrawn from the scheme, for reasons including “changes in business direction and ownership at the practice level”.

The department denied suggestions that it was applying different rules to make it easier for corporates to take part.

“The stage-one trial of Health Care Homes is being applied consistently across the diverse range of business models that exist in general practice without modifying the terms and conditions that individual practices need to meet,” the department said. “It is important that the trial is a nationally consistent model and also able to adapt to locally available services, to provide the best range of access for people with chronic and complex conditions.”

Changes in documentation had been made to better reflect relevant business models.

“These changes do not benefit one practice over another or change the requirements for participating in the trial.”

The department said it was contacting the remaining shortlisted practices which have their documentation, “to firm up responses” before it made offers to a reserve list of 136 practices.

Some 461 practices had initally applied to take part in the trials.