Health Care Homes trials facing boycott

A half-baked chronic health response could well make things worse, says the College

The RACGP has disowned Health Minister Sussan Ley’s Health Care Homes scheme, saying it bears no resemblance to the plan it championed to fight Australia’s rising chronic disease epidemic.

College president Dr Bastian Seidel has called on members to boycott trials of the scheme unless the minister puts off the planned July starting date and embarks on a redesign which includes increased funding.

Minister Ley last week extended the deadline for general practices to signal interest in joining the trials, allowing them an extra week until December 22.

Meanwhile, GP groups have demanded the trials be suspended for at least three to six months.

A recent statement from Ms Ley’s office left open the possibility of a postponement, saying the minister would take advice on “key factors” associated with the trials.

But the RACGP has ramped up its criticism, with Dr Seidel suggesting a half-baked effort could end up being damaging to patients.

“The Health Care Homes model is a capitation funding model for treatment of chronic medical conditions.  It does not in any way represent the RACGP’s ‘medical home’, which is an evidence-based clinical model that leads to improved health outcomes – supported by increased funding for general practice patient services,” Dr Seidel wrote.

“There are serious concerns regarding capitated funding for chronic disease management and treatment.  It may harm patients, and it may undermine GP-led care when funding runs out.”

Dr Seidel last week said the scheme was significantly underfunded and poorly planned, and the federal government was not taking the concerns of GPs and their patients seriously.

The program is aimed at dealing with managing chronic disease through patient-centred primary care using a blended payments system with patients divided into tiers according to their condition.

Announcing the initiative in March, Ms Ley said it was a reform to revolutionise Medicare. Then RACGP president Dr Frank Jones called the move “a great win”, praising the government for taking the College’s advice to adopt the medical home model.

But doctors now fear the implementation will be too rushed and under-resourced to develop an evidence base.

The government has allocated a little more than $100 million to support the rollout of stage one, which aims to enrol up to 65,000 patients in 200 medical practices in 10 regions across Australia.

“It is voluntary for medical practices and patients and no doctor is required to participate if they do not want to,” Ms Ley said.

She said the development of stage one of Health Care Homes had included doctors’ views through an advisory group.

Participation is sought from general practices and Aboriginal Health Services in the PHN regions of Perth North; Northern Territory; Adelaide; Country South Australia; Brisbane North; Western Sydney; Nepean Blue Mountains; Hunter, New England and Central Coast; South Eastern Melbourne; and Tasmania.