To improve primary care access and affordability under Medicare we should look at what’s worked overseas
After decades of neglect, there are many problems to fix. Clinics often don’t have the right mix of staff, collaborating with specialists and hospitals is difficult, data systems are fragmented, and there are parts of Australia with poor access to care.
One issue the taskforce must consider is how GP clinics are funded. While a simple boost to fees may be welcomed by practices, it can’t deliver the better access, qualityand affordability that Labor has promised. Australia’s approach has outlived it’s used-by date.1. Blend payments to strike the right balance
Australia is one of a small and shrinking list of countries that still mostly uses fee-for-service funding. There are payments to make care plans, and for working toShorter visits pay more, promoting a focus on speed not need – a poor fit for helping patients with complex needs. Since the 1990s, many other countries have moved towards a “blended” funding model. After a patient enrols with a particular doctor or clinic, GPs have ongoing responsibility for their patients and get flexible annual budgets for their care, along with a small fee for each visit.
This supports continuity of care and gives flexibility to provide different types of services, while keeping an incentive for GP consultations. It strikes a good balance between GP visits and other kinds of care, such as check-ins with a practice nurse, medication reviews from a practice pharmacist, or even support that goes beyond health care, such as help with housing or community services.