Australian Health Care Homes trial: case study
Jane Hall · Kees van Gool · Philip Haywood · Jim Pearse · Deniza Mazevska · Serena Yu · Michael Wright · Peyman Firouzi Naeim
Oct 2023 · World Health Organization
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64
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About this ebook
This report was developed to inform the WHO Technical Product, purchasing instruments to strengthen quality health services for chronic illnesses (WHO-OECD joint publication).
The Australian primary care system largely consists of independent private medical practices funded by fees for services. A Health Care Homes model that included voluntary patient enrolment and voluntary provider participation, with bundled payment for chronic disease management was implemented as a trial from October 2017 to June 2021. The model aimed to provide more flexible services delivered by multidisciplinary teams. Previous attempts to introduce patient enrolment supported by capitation had mixed results. The trial design of this involved a variety of stakeholders. Practices did not become purchasers of other services, and careful attention was paid to identifying and risk-rating suitable patients. The evaluation of the trial demonstrated some improved disease management and more use of a variety of practitioners without any significant change in hospital use. The decrease in fee-for-service revenue was more than compensated for by the capitated payments.
The Australian primary care system largely consists of independent private medical practices funded by fees for services. A Health Care Homes model that included voluntary patient enrolment and voluntary provider participation, with bundled payment for chronic disease management was implemented as a trial from October 2017 to June 2021. The model aimed to provide more flexible services delivered by multidisciplinary teams. Previous attempts to introduce patient enrolment supported by capitation had mixed results. The trial design of this involved a variety of stakeholders. Practices did not become purchasers of other services, and careful attention was paid to identifying and risk-rating suitable patients. The evaluation of the trial demonstrated some improved disease management and more use of a variety of practitioners without any significant change in hospital use. The decrease in fee-for-service revenue was more than compensated for by the capitated payments.
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