Commonwealth's Health Care Home

Australia’s health system is facing unprecedented challenges, both in terms of workforce and financial pressure, in dealing with an expanding, ageing population with its associated burden of chronic conditions.  The hospital system is experiencing increases in potentially preventable hospitalisations and general practice is facing the challenge of managing the growing complexity and multi-faceted needs of patients in a model of care that is funded for acute presentations and face to face consultations.  A fundamental shift in the way care is delivered in the community is required in order to sustainably deliver better health outcomes particularly for those at risk of poor outcomes.

A Primary Health Care Advisory Group (PHCAG) was established by the Commonwealth, with its discussion paper Better Outcomes for People with Chronic and Complex Health Conditions released at the end of 2015.  PHCAG had a number of key recommendations including the establishment of a new model of primary health care coined the Health Care Home.  The Commonwealth responded to these recommendations with its Health Care Home policy in March 2016. The Health Care Home will co-ordinate all of the medical, allied health and out-of-hospital services required as part of a patient’s tailored care plan. Health Care Homes will be delivered by GP practices or Aboriginal Medical Services.

The model is underpinned by payment reform with the allocation of tiered bundled payments to practices depending on individual patient complexity.  The expectation is that this change will enable providers to be flexible and innovative in how they communicate and deliver care, and will ensure that the patient’s health care needs are regularly monitored and reviewed. This signals a move away from the current face to face fee-for- service model for these eligible patients, except where a routine health issue does not relate to their chronic illness.

Internationally this model of care, often called the Patient Centred Medical Home, has produced improved health outcomes, along with a reduction in health care utilisation and costs.