The benefit of health care homes
THE Rural Doctors Association of Australia (RDAA) says genuine commitment is needed from both the healthcare sector and Federal Government to ensure the forthcoming trial of the Health Care Homes initiative is a success in delivering guidance on how the initiative will work to best effect in the longer-term.
RDAA president, Dr Ewen Mcphee (pictured), said while the Association is actively encouraging its rural doctor members to participate in the trial, it will be crucial for the Government to undertake rolling evaluation of the trial and to respond quickly if any practices experience negative financial or other impacts while participating.
He added that, should not enough rural or remote practices and Aboriginal Community Controlled Health Services express interest in participating in the trial, the Government should quickly reassess the level of support it is offering to encourage participation.
"The trial will need a high participation rate — and a genuine evaluation process, undertaken in full and open consultation with practices and stakeholder bodies — to help ensure that any problems are ironed out before longerterm implementation of the Health Care Homes initiative occurs" Dr Mcphee said.
"Having too small a sample size, and implementing only a cursory evaluation process, will risk delivering a sub-optimum initiative that could cost the Government more than the existing chronic healthcare approaches it is designed to replace."
Dr Mcphee said that realistic funding for general practices and Aboriginal Community Controlled Health Services participating in any longer-term phase of the Health Care Homes initiative would also be essential in ensuring its longterm sustainability.
"Our take home message is let's not throw the baby out with the bath water on this issue — the Health Care Homes initiative has the potential to be a very positive development in chronic care, but we need to get the levers right to make it so" he said.
"It is critical that the medical community engages constructively with the Government on the trial, particularly if we are to fully understand what enhancements are needed to make the full-scale implementation of the Health Care Homes initiative effective for the long-term.
"But equally, the Government needs to work with the profession now to ensure the trial goes well.
"For example, while we are keen to have rural practices participate in the trial, there is a dearth of contractual detail available around how practices get involved and only a basic level of support funding available to assist them to participate — this is discouraging many practices, both rural and urban, from participating.
"Yet the views of rural and remote practices participating in the Health Care Homes trial will be essential in shaping a sustainable Health Care Homes initiative for the years to come. "We understand that the Government wants to enter into the Health Care Home trial phase with a lean funding approach, and will only want to invest more once it has been proven that the initiative has merit in the longer-term.
"But it is essential that the trial highlights what the real cost to practices will be in becoming Health Care Homes — because, going forward, practices must be fully compensated for the service they are providing, or the initiative will simply fall over.
"RDAA has welcomed the Government's decision to implement the Health Care Homes trial, and we have been working closely with the Government to provide feedback on the initiative from a rural and remote perspective.
"We will continue to engage going forward, as it is critical the Government hears directly from us what is working and what is not working during the Health Care Homes trial phase.
"A successful trial of the Health Care Homes initiative — when backed up by genuine evaluation and realistic funding — should pave the way for a sustainable and effective long-term approach to chronic care in Australia.
"That is an outcome definitely worth working for."