All GPs understand the importance of continuity of care and the positive impact that getting to know a patient over time and establishing a true therapeutic relationship can have on patient outcomes.
The medical home or (in Australia) ‘Health Care Home’ model recognises the benefits of a strong patient-health provider relationship and provides incentives for care to be primarily coordinated by the patient’s chosen GP.
This is not an entirely new concept in Australia. Many practices already participate in initiatives, which share similar characteristics to the proposed Health Care Home model.
For example, there are practices participating in the Closing the Gap initiative, which allows Aboriginal and Torres Strait Islander patients to register and nominate a principal practice for the delivery of their care.
There are also several practices participating in the Department of Veteran Affairs’ CVC Program familiar with the concept of ‘enrolling’ a patient to provide ongoing and comprehensive care coordination services funded through Practice Incentive Payments.
With this in mind, the introduction of a Health Care Home model for Australian practices is likely to expand the central role GPs already play in coordinating multidisciplinary services for patients with complex health needs.
This will hopefully be recognised and supported with an adequate level of funding to help cover some of added time and costs incurred by practices participating in the ‘Health Care Home’ program.
Practice nurses will also play a key role in the successful implementation of these Health Care Homes. We may see a welcome expansion to their scope of work that recognises the care coordination and service ‘navigation’ work that often goes unnoticed (and unfunded).
The potential benefits of the Health Care Home model are considerable, but before we get too carried away, a word of warning: with added funding, comes added accountability.
Every new initiative comes with its own set of audit requirements, patient eligibility parameters, and documentation and reporting requirements.
Let’s not forget the concerns raised throughout the introduction and rollout of GP Management Plans (GPMPs) and Team Care Arrangements (TCAs), which were largely caused by the documentation and complex eligibility process attached to claiming the related item numbers.
This is why a gradual rollout accompanied by comprehensive training and support with practice-relevant and patient-friendly resources will be essential to the successful introduction and countrywide rollout of the Health Care Homes model in Australia.
