Government under pressure to step up commitment to the “Health Care Home” plan for managing chronic disease
In the final stretch of the federal election campaign, the government is under pressure to step up its commitment to the “Health Care Home” plan for managing chronic disease.
The AMA last week lashed the government for its paltry $21 million investment in the trial phase of what Prime Minister Malcolm Turnbull claimed would be one of the biggest health system reforms since the introduction of Medicare.
AMA President Dr Michael Gannon said the project would be doomed unless the government put up a meaningful level of funding.
“The government seems to expect that GPs will be able to deliver enhanced care for patients with no extra support,” he said. “We want the Health Care Home model to work, but the government needs to back it with appropriate funding.”
RACGP President Dr Frank Jones said he shared concerns about the scheme’s funding as well as a lack of clarity around the design.
“Conceptually, every party understands the advantages of having the medical-home model,” he told TMR. “Funding is critical, because if there’s not enough money put into the equation, whatever the design is, it will fail.”
Announced in March, the Health Care Home trials are to take place around the country over two years from 1 July, 2017, involving 65,000 patients and 200 practices. Practices in 10 Primary Health Networks will shortly be invited to apply to take part, TMR has been told.
But the AMA said it understood the government had failed at a Council of Australian Governments meeting in April to win the agreement of states and territories to redirect $70 million per year of public hospital funds to support the trials.
Dr Gannon said the rejection of the $140 million proposal, apparently revealed in a leaked meeting document, suggested the trial was seriously underfunded.
Labor, pushing to make health the pivotal issue of its campaign, earlier pledged $100 million over the two years to develop its version of patient-centred medical homes dubbed “Your Family Doctor”.
In response to the AMA’s attack, Health Minister Sussan Ley’s office on Friday said the government would, if re-elected, find about “$100 million” to help fund co-ordinated care packages for chronically ill patients beyond the trials.
The money would be sourced from “existing Medicare funds,” the minister’s office confirmed.
The government seized on the RACGP’s concept of patient-centred “medical homes”, including a shift away from fee-for-service payments, as a means of keeping patients with chronic disease out of hospital and easing costs.
Doctors applauded the move, and the evident political backing, after Mr Turnbull joined Ms Ley on 31 March to launch the policy, which the pair said would “revolutionise the way we care for Australians with chronic diseases and complex conditions”.
But disappointment set in when the government set aside no extra money for the plan in the 3 May budget, apart from the initial $21.3 million for the two-year design and evaluation phase.
The government intends to use the trial period to work out deals for the states and private insurance companies to contribute to the care packages, although no arrangements are locked in as yet.
“The care costs will come from various sources – redirected Medicare payments, state government contributions, individual contributions from patients, and the private health insurers,” Dr Steve Hambleton, former head of the minister’s Primary Health Care Advisory Group, said.
Labor said its investment would help develop “a unique Australian model of patient-centred medical homes”.
“Labor will ensure an appropriate mix of launch sites in metropolitan, regional and rural areas, so that the models developed meet the needs of all Australians.”
