Volume 196 - Issue 9
Designing payments for GPs to improve the quality of diabetes care
Authors: Tim Fountaine, Jonathan E Shaw and Paul Z Zimmet
Med J Aust 2012; 196 (9): 568. || doi: 10.5694/mja12.10302
Published online: 21 May 2012
Published online: 21 May 2012
To the Editor: We read Scott and Harris’s1 article with great interest and agree that new funding models for diabetes care must be carefully designed to ensure that interventions are effective. For this reason, the Diabetes Care Project2 (formerly the Coordinated Care for Diabetes Pilot) developed pilot interventions following reviews of international trials and extensive ...
To the Editor: We read Scott and Harris’s1 article with great interest and agree that new funding models for diabetes care must be carefully designed to ensure that interventions are effective. For this reason, the Diabetes Care Project2 (formerly the Coordinated Care for Diabetes Pilot) developed pilot interventions following reviews of international trials and extensive consultation with leading experts, including the Diabetes Advisory Group (of which the Australian Medical Association, Royal Australian College of General Practitioners and Diabetes Australia are members) and the Baker IDI Heart and Diabetes Institute. A broad cross-section of Australians with diabetes, general practitioners, practice nurses, diabetes specialists and allied health professionals were also involved.
The new funding model is one component of a holistic model of care that also includes a new information technology system to support care planning, a new care facilitator role, and education and capability building. The funding model has three core principles:
risk-adjusted flexible funding for allied health professional services and for care planning and reviews — evidence-based indicators, such as glycated haemoglobin and end-organ damage, ensure that more funding is directed towards patients with more complex needs, avoiding the financial risk borne by practices that work with such patients
retention of most current Medicare Benefits Schedule fee-for-service payments
incentive payments that reward improvements in patient outcomes (not just achievement of specific targets) and experience, and reward existing high levels of care.
This combined funding model is expected to increase resources for the majority of practices. We are excited that the pilot will contribute to developing new models for increasing the quality of diabetes care for Australians.
Competing interests
Jonathan Shaw and Paul Zimmet received a fee from McKinsey and Company for help in designing the care program being piloted in the Diabetes Care Project. Paul Zimmet also received support from McKinsey and Company to travel to Canberra to attend a Diabetes Advisory Group meeting for the project. McKinsey and Company won the tender from the Department of Health and Ageing to design and implement the Coordinated Care for Diabetes Pilot on behalf of the federal government.
References
- Scott A, Harris MF. Designing payments for GPs to improve the quality of diabetes care. Med J Aust 2012; 196: 24-26. 0_CHDGGFHG
- Diabetes Care Project [website]. https://www.dcp.org.au (accessed May 2012).