Four recommendations from Strengthening Medicare Taskforce

The federal government has released the Strengthening Medicare Taskforce report that outlines recommendations for reforms to strengthen Medicare and rebuild general practice.

Minister for Health and Aged Care Mark Butler said, “Medicare has been the crowning achievement of our health system for 40 years, but it is time for reform. Now is the time to ensure Medicare delivers the kind of primary care Australians expect, both now and into the future.

“Our government has committed $750 million to the Strengthening Medicare Fund, which will be the start of a major revamp of the primary care system.

“I would like to express my sincere thanks to each member of the Strengthening Medicare Taskforce for their hard work and insights. This is an important foundation for the work to come in modernising and improving Medicare. The improvements they have identified are aimed at making sure every Australian can get the high-quality care they deserve,” Butler said.

Developed by primary healthcare leaders and experts in their fields, the report identifies where government “needs to invest now to rebuild primary care as the vibrant core of an effective, modern health system”.

The report, with a four-point vision for strengthening Medicare, calls on the government to “back this investment with practical actions, clear accountability for driving outcomes and comprehensive support for the sector to manage change”.

“This report reflects the consensus view of the individual members of the Taskforce. It should not be read as reflecting any particular peak body or organisation’s views,” said the Taskforce. Below are the highlights:

Increasing primary care access

The Taskforce makes six recommendations to improving and increasing access to primary care, regardless of where people live and when they need care, with financing that supports sustainable care and a system that is easy to navigate for people and care providers.

• Support general practice in management of complex chronic disease through blended funding models integrated with fee-for-service, with funding for longer consultations and incentives that better promote quality bundles of care for people who need it most.
• Support better continuity of care, a strengthened relationship between the patient and their care team, and more integrated, person-centred care through introduction of voluntary patient registration. This needs to be supported with a clear and simple value proposition for both the consumer and their general practice or other primary care provider. Participation for patients and practices needs to be simple, streamlined and efficient.
• Develop new funding models that are locally relevant for sustainable rural and remote practice in collaboration with people, providers and communities. Ensure new funding models do not disadvantage people who live in communities with little or no access to regular GP care, and whose care is led by other healthcare providers.
• Grow and invest in Aboriginal Community Controlled Health Organisations (ACCHOs) to commission primary care services for their communities, building on their expertise and networks in local community need.
• Strengthen funding to support more affordable care, ensuring Australians on low incomes can access primary care at no or low cost.
• Improve access to primary care in the after-hours period and reduce pressure on emergency departments by increasing the availability of primary care services for urgent care needs.

Multidisciplinary team-based care

The Taskforce suggests incentivising primary care to work with other parts of the health system, with appropriate clinical governance, to reduce fragmentation and duplication, and deliver better health outcomes to all Australia. Below are the key recommendations:

• Fast-track work to improve the supply and distribution of GPs, rural generalists, nurses, nurse practitioners and midwives, pharmacists, allied health, Aboriginal and Torres Strait Islander health workers and other primary care professionals.
• Work with states and territories to review barriers and incentives for all professionals to work to their full scope of practice.
• Increase investment in the Workforce Incentive Program to support multidisciplinary teams in general practice, improving responsiveness to local need, increasing accountability and empowering each team member to work to their full scope of practice.
• Support local health system integration and person-centred care through Primary Health Networks (PHNs) working with Local Hospital Networks, local practices, ACCHOs, pharmacies and other partners to facilitate integration of specialist and hospital services with primary care, and integrate primary care with mental health, aged care, community and disability services.
• Increase commissioning of allied health and nursing services by PHNs to supplement general practice teams in underserved and financially disadvantaged communities.

Technology and data sharing

Digital technology can help share critical patient data to improve diagnosis, care and management and provide insights for planning, resourcing and continuous quality improvement. Below are five key recommendations from the Taskforce:

• Modernise My Health Record to significantly increase the health information available to individuals and their health care professionals, including by requiring ‘sharing by default’ for private and public practitioners and services, and make it easier for people and their healthcare teams to use at the point of care.
• Better connect health data across all parts of the health system, underpinned by robust national governance and legislative frameworks, regulation of clinical software and improved technology.
• Invest in better health data for research and evaluation of models of care and to support health system planning. This includes ensuring patients can give informed consent and withdraw it, and ensuring sensitive health information is protected from breach or misuse.
• Provide an uplift in primary care IT infrastructure, and education and support to primary care practices including comparative feedback on their practice, so that they can maximise the benefits of data and digital reforms, mitigate risks and undertake continuous quality improvement.
• Make it easier for all Australians to access, manage, understand and share their own health information and find the right care to keep them healthy for longer through strengthened digital health literacy and navigation.

Supporting change management

The Taskforce envisions a primary care sector that is well supported to embrace organisational and cultural change, and drive innovation. Recommendations include:

• Put consumers and communities at the centre of primary care policy design and delivery. Allow for flexibility in models of care to deliver on local needs and incentivise innovation to deliver better health outcomes.
• Learn from both international and local best practice, and invest in research that evaluates and identifies models of high value primary care excellence.
• Work with providers to help them effectively manage change and transition to new ways of working, including through a strengthened role for PHNs to support the adoption of successful, locally designed models of care.
• Support the continued development of practice management as a profession, including through an initial training program to help practices transition to new ways of working.
• Implement a staged approach to reform, supported by an evaluation framework to monitor progress and measure the impact of reforms.
   

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