Elderly chronically ill patients could be encouraged to enrol with a GP. Picture: istock
Elderly chronically ill patients could be encouraged to enrol with a GP. Picture: istock

$400m plan to keep patients out of hospital

PATIENTS with chronic illnesses like diabetes will get extra Medicare funding when they enrol with a single GP under a radical new system the government is expected to fund in next Tuesday's budget.

The program which could cost $400 million over four years is

Doctors and nurses would proactively call chronically ill patients to check on their health and could intervene early if blood sugar readings started to rise or blood pressure became dangerous, heading off hospitalisations.

The medical practice would receive lump sum payments every three months to fund proactive comprehensive care packages including telehealth and electronic consultations for each chronically ill patient enrolled.

It is believed the scheme will be initially aimed at older Australians.

 

Elderly chronically ill patients could be encouraged to enrol with a GP. Picture: istock
Elderly chronically ill patients could be encouraged to enrol with a GP. Picture: istock

 

A similar scheme in Denmark that boosted spending on GP care has seen the number of hospitals more than halved from 98 in 1999 to 32 today.

Doctors want the program modelled on Australia's successful Coordinated Veterans' Care Program (CVC Program) for military veterans that has helped reduce costly hospital visits among chronically ill patients.

Under that program GPs are paid $432 each quarter to care for patients but the budget scheme is not expected to be this generous.

The government's Medicare Benefits Review late last year called for such a GP enrolment system and proposed a new fee for practices and GPs for enrolling a patient.

"Consumers should be able to enrol with a practice, and nominate a GP within that practice, with flexibility so patients can see other providers within the practice," the review said.

The review also called for new Medicare funding for non-face-to-face GP consultations via telephone, email, video consulting, telehealth where the patient was enrolled with the GP practice.

"There is an economic business case for this because it is more effective use of taxpayers money," Australian Medical Association chief Dr Tony Bartone said.

RACGP President Dr Harry Nespolon backs the concept but says the success of the plan will depend on funding.

"If the payments are not enough it will fail," he said.

 

Dr Harry Nespolon says new system needs to be well funded to succeed. Picture:  Danielle Butters
Dr Harry Nespolon says new system needs to be well funded to succeed. Picture: Danielle Butters

 

The government has been trialling a similar scheme called Health Care Homes but it has been heavily criticised because it does not properly fund the extra GP care.

A national health performance authority report in 2015 found around 880,000 "frequent flyer" patients saw their GP more than 20 times a year and soaked up 17 per cent or $2.8 billion of non-hospital spending. Nearly half of them ended up in hospital.

It is hoped the more intensive care under the new GP enrolment system will reduce these hospitalisations.

The budget is also expected to deliver more funding for GPs who provide after hours care and nursing home visits.

The government has already announced the budget will provide $62.2 million over four years to fast track implementation of a National Rural Generalist Pathway for Australia.Rural doctors to skill rural GPs in obstetrics, anaesthesia and other specialities.

The government has already announced it will index Medicare rebate for X-rays for the first time in nearly two decades reducing the out of pocket expenses patients face.

 

The government has already announced it will increase Medicare rebates for X-rays. Picture: iStock
The government has already announced it will increase Medicare rebates for X-rays. Picture: iStock

 

GP groups are also hoping the budget will increases the amount Medicare pays doctors for longer consultations.

The Royal Australian College of General Practitioners says Medicare rebates for consultations of between 20 and 40 minutes to be increased from $72.80 to over $86.

Consultations lasting between 40 to 60 minutes should be increased from $107.15 to over $123.

"Patients with complex conditions are less supported by Medicare when they visit their GP, compared to those who only need smaller amounts of time," said Dr Nespolon.

The government's MBS review has also called for a new Medicare rebate for consultations lasting 60 minutes or more.