By 2025, practices will only be able to receive PIP IHI payments when the patient has received a threshold level of care.
Major reforms to Practice Incentives Program’s Indigenous Health Incentive (PIP IHI) are rolling in from January 2023, as the program shifts to a “back-ended payment structure”.
The restructures will culminate in the elimination of the registration payment in January 2025.
Practices will still be able to claim $100 at tier 1, and the tier 2 payment will double to $300, for a total of $400 per patient.
This will be a decrease from the current maximum of $500, but any loss in income may be offset by the fact that program eligibility will expand to include Indigenous children under the age of 15.
The Department of Health said that the back-loaded payment structure, which essentially shifts the focus from registering patients to delivering outcomes, is “intended to improve continuity of care and health outcomes for Aboriginal and Torres Strait Islander people with a chronic disease”.
All GP practices will still receive the one-off $1000 payment when they register for the PIP IHI program.
Under the current structure, practices receive $250 when a patient is registered and $100 when the patient reaches tier 1, defined as when a practice prepares and reviews a GP management plan or completes two reviews of an existing plan.
There’s a final $150 payment when the patient reaches tier 2, which is when practice has delivered a minimum of five MBS services.
To be eligible for the tier 1 and 2 payments, services had to take place in the same calendar year that the patient was registered in.
The restructure is set to take place in three stages.
From January 2023, the following changes come in:
- Registration payment decreases by $100 to $150.
- Tier 1 and 2 payments will become payable for Indigenous children under the age of 15.
- GP mental health treatment plans will be counted toward the tier 1 and 2 outcome payments.
- The timeframe in which to deliver services will change from one calendar year to a 12-month window from the date that the first service is delivered.
From January 2024, the following changes come in:
- Registration payment decreases by $50 to $100.
- Tier 2 payment increases by $50 to $200.
- Practices will no longer need to re-register patients each year – all registrations from 2024 onward will become ongoing unless a patient withdraws their consent.
From January 2025, the following changes come in:
- Registration payment decreases by $100 to $0.
- Tier 2 payment increases by $100 to $300.
