A redesigned PIP will encourage more sharing and analysis of patient information
GPs will be asked to generate more data to measure the “quality improvement” of their patient care under a new Practice Incentive Payments scheme.
The PIP redesign will result in a simplified model as of May next year, with only four of the 11 existing payments to remain unchanged under current proposals. They are the rural loading, the after-hours incentive, the teaching payment and the eHealth incentive.
A new quality-improvement incentive was proposed to streamline the system, driven by continuous data sharing and feedback, a Health Department consultation paper said.
“A redesigned PIP is likely to require general practices to frequently provide de-identified data (to a yet-to-be-determined entity) from their practice software systems,” it said.
Data management would need to reflect the long-term aim of lifting quality, with practices to be rewarded for “quality care, continuous improvement and data-driven quality”.
This would require data analysis to be undertaken monthly or quarterly to “inform the continual feedback loop”, the paper said.
It noted “synergies” between data requirements for the new PIP and the Health Care Homes initiative, also due to start trials next year.
In one scenario, eligible practices could receive a sign-on payment, quarterly payments for providing data from practice systems and engaging in quality improvement activities, and further payments for measuring performance and making progress.
“Practices would choose their improvement activities and submit de-identified data regularly via an automated data extraction tool,” the paper said.
“The data would then be aggregated to provide a national picture of Australian primary health care and inform policy at a national level.”
In a second option, practices could engage a third-party quality-improvement provider that would receive the PIP and reward practices for participation in quality-improvement efforts.
The new PIP would support the Health Care Homes initiative, with the aims of improving indigenous health, access and equity of care, detection and management of chronic conditions, and data and information systems.
Although the redesign will bring “savings” of $21.2 million in PIP funds, to be used to help pay for the Health Care homes trials, “it is anticipated that the quantum of funds to be available through the PIP will be unchanged”.
The paper referred to a consensus on the need for funding models to reward the value of care rather than volume.
“The announcement of Health Care Homes signals a renewed desire to move away from a fee-for-service model in general practice and will use bundled payments, a form of capitation,” it said.
“However, there is uncertainty in how to make that shift in regard to the PIP.”
The consultation is open to submissions until November 30. GPs can also comment or fill in a questionnaire at consultations.health.gov.au.
