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For love or money? Changing the way GPs are paid to provide diabetes care

Doris Young, Anthony Scott and James D Best
Med J Aust 2010; 193 (2): 67-68.
Published online: 19 July 2010

Will it bring about real behavioural change in general practice?

Achieving high-quality and cost-effective care for those with chronic disease requires changes in the behaviour of both doctors and patients. In the past, fragmented policy has led to fragmented management of chronic disease, and there is now an opportunity for change. A new payment scheme for the care of people with diabetes, proposed as part of the federal government’s National Health and Hospitals Network, is centred on patients voluntarily enrolling with a practice and general practitioners being paid in a way that changes their behaviour.1 The proposal is worth $449.2 million over 4 years or up to $10 800 annually per practice, and includes a sign-up payment of $1500 per practice, voluntary patient enrolment, capitation payments ($100 per patient) and annual payments of up to $950 per patient linked to “keeping . . . patients healthy and out of hospital”.

  • Doris Young1
  • Anthony Scott2
  • James D Best3,4

  • 1 Department of General Practice, University of Melbourne, Melbourne, VIC.
  • 2 Melbourne Institute of Applied Economic and Social Research, Faculty of Business and Economics, University of Melbourne, Melbourne, VIC.
  • 3 Department of Endocrinology and Diabetes, St Vincent’s Hospital, Melbourne, VIC.
  • 4 Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC.

Correspondence: d.young@unimelb.edu.au

Competing interests:

Doris Young and James Best are funded as chief investigators for the National Health and Medical Research Council (NHMRC) Centre for Clinical Research Excellence in Clinical Science in Diabetes. Their institutions have received grants from the NHMRC and the Australian Department of Health and Ageing. Doris Young receives payment as a member of the NHMRC Healthcare Committee and for related travel and accommodation expenses. James Best is employed part-time as chair of the NHMRC Research Committee and receives money for travel and accommodation expenses related to this role. Anthony Scott is supported by an Australian Research Council Future Fellowship and has received Stream 13 funding from the Australian Primary Health Care Research Institute. His institution has received support for his travel to meetings.

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