Health Care Homes

Delivery

Adelaide PHN has been provided with dedicated resources to assist each participating general practice with their transformation into a 'Health Care Home'.

Eligible patients can voluntarily enrol with a participating Health Care Home and recieve coordinated, integrated care, tailored to their needs. 

The Health Care Homes stage one roll out is already underway across Adelaide, one of the ten regions selected for involvment in the trial.

Central elements of the Health Care Homes trial include:

  • Health Care Homes
    A Health Care Home is an existing general practice or Aboriginal Community Controlled Health Service that further commits to a systematic approach to chronic disease management in primary care. This vision is for Health Care Homes to deliver better coordinated, more comprehensive, personalised care; improve timely access to health care and services; empower and engage people and their families in their care; and to improve people’s health outcomes and satisfaction with the care they receive.
     
  • Care teams
    The team of health professionals, led by a Health Care Home GP, who help develop and deliver a person’s shared care plan
     
  • The creation of shared care plans
    A person’s tailored care plan which is accessible electronically by all those involved in the care of a person and fosters proactive planning, monitoring, and coordination of care between health professionals
     
  • Bundled payments
    During stage one of the trial, a Health Care Home receives reimbursement according to a blended bundle payment model rather than receiving a standard fee-for-service and/or practice incentive payment (provided under the Medicare Benefits Schedule (MBS) and Practice Incentive Program (PIP)). 

    A Health Care Home will receive a bundled payment for the care they provide to people enrolled in the trial when that care is relating to that person’s chronic and complex condition(s). Bundled payments are tiered, that is they are linked to the complexity of that person’s care and need. Each payment is made directly to the participating practice monthly, on a  pro-rata, retrospective basis. Standard payments (i.e. MBS & PIP related payments) are only received by a Health Care Home, when they provide care to people either NOT enrolled in the Health Care Home Trial, OR they provide care which is unrelated to an enrolled person’s chronic condition. 

    This bunded payment approach aims to give participating Health Care Homes more flexibility and should reduce paperwork.

 

Practice Facilitators

One of the main ways the Adelaide PHN is supporting the Health Care Homes trials is via the recruitment of specialist trainers called Practice Facilitators. These facilitators are working to support the transformation of participating Adelaide region practices to become Health Care Homes. Our Practice Facilitators have been trained to have a strong understanding of the Health Care Homes concepts, and are providing practices with tailored support including assisting them with administration and analysis of Health Care Home’s tools, embedding quality improvement frameworks into their practises, establishing measurement strategies and reviewing data, and providing data for the trial’s stage one evaluation.