The trial of a new approach to supporting people with chronic disease will encourage GPs to offer telehealth services, a member of the digital health agency says.
The Federal Government is funding a $21 million two-year trial starting later this year involving 200 general practices acting as the health care home for up to 65,000 Australians with chronic and complex conditions.
The providers will be funded through bundled monthly payments to coordinate care for patients, who will be supported to self-manage their chronic disease, and develop a shared care plan.
Australian Digital Health Agency board member Dr Eleanor Chew told the Australian Telehealth Conference last week that bundled payments encouraged providers to be innovative and flexible in how they communicated and delivered care.
“The health care home and the patient determine how a bundled payment is utilised, allowing for contact that is not face-to-face, such as through telehealth services,” Dr Chew said.
The management of chronic and complex conditions by GPs is currently funded by a fee-for-service and Medicare rebates are only paid for services delivered in person.
Dr Chew said a key feature of the health care home was enhanced access to alternative services enabled by telephone, email or video conferencing and potentially supported by digital health and home monitoring devices.
Telehealth funding model: need to move from fee-for-service to bundled payments that reduce fragmentation and increase coordination #ATC17
— Tasneem Islam (@technursetas) April 27, 2017
The new model aims to rein in expanding healthcare costs primarily attributed to an ageing and overweight population that is leading to increased incidences of chronic diseases such as heart failure, COPD and diabetes.
People aged over 65 make up 13 per cent of the population but 40 per cent of hospital admissions, Dr Chew said.
Along with cost savings, known benefits of health care home models included increased access to appropriate care coupled with decreased use of inappropriate services, the provision of more preventive services and improved experiences for patients and providers, she said.
— Josie Di Donato (@josie0181611) April 27, 2017
‘A significant shift’
Telehealth in Australia is currently focused on specialist consultations to patients in rural and remote areas and Medicare rebates are only available to GPs providing face-to-face clinical support to patients during the video consultation with the specialist.
Dr Chew said bundled payments represented a significant shift in how GP services were funded in Australia and while they posed some financial risk to practitioners there was potential for reward for efficient and effective care coordinators.
“For example, if GPs delivered care via telehealth consultations rather than face-to-face consultations, it would be financially advantageous to both the clinician and the patient,” she said.
- Around 20 per cent of Australians and 40 per cent of Australians over 45 have at least one chronic condition
- Medicare spending is projected be the fastest growing area of Australian Government expenditure over the coming decades
- Risk factors for chronic conditions such as obesity are at high levels and increasing
- There is a potentially preventable hospitalisation for chronic disease in Australia every 2 minutes and a diabetes related amputation every 2-3 hrs
- Nearly a quarter of people who visited an emergency department felt their care could have been provided by a GP
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