Building better foundations for primary care

by Stephen Duckett, Hal Swerissen

01.05.2017 report

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Simple reforms to Australia’s health system could help save more than $320 million a year on avoidable hospital admissions and provide better care for people with diabetes, asthma, heart disease and other chronic conditions.

The primary health system, Australians’ first point of contact for health care, was designed in and for another era and is now failing in the prevention and management of chronic disease, the heaviest burden on today’s health system.

The government spends more that $1 billion each year on planning, coordinating and reviewing chronic disease management, yet many people with chronic conditions do not receive best care and end up having hospital stays that could have been avoided with better care.

Medicare’s fee-for-service payment system for one-off visits to GPs needs to change, in favour of broader payments to health teams for integrated, long-term care of patients with chronic conditions. GPs would be financially rewarded for getting the best results for their patients, rather than for seeing their patients more often.

The 2017 federal budget is expected to commit more than $½ billion over the next few years to lifting the Medicare rebate freeze. The Government should seize this opportunity to require in return that GPs provide more data on why people visit their doctor and what advice and treatment they get. This data will enable general practices to compare their performance with their peers. It will also enable the development of payment systems to reward improved patient management.

The bickering and blame-shifting between the Commonwealth and the states needs to stop. The federal government should sign an agreement with each state that sets specific goals for disease prevention and management.

Under these agreements, Primary Health Networks should be given more responsibility to create more effective and efficient primary care systems in their local areas, and should be held accountable for making improvements that reduce unnecessary hospital admissions.

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