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Queens Health Policy Change Conference Series Australian Health Reform Progress. Prof Mick Reid May 2014. Health /Hospital Boards. Most States have created District Hospital Boards - Devolved authority from State Authorities. - I ncreased local autonomy .
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Queens Health Policy Change Conference SeriesAustralian Health Reform Progress Prof Mick Reid May 2014
Health/Hospital Boards Most States have created District Hospital Boards - Devolved authority from State Authorities. - Increased local autonomy. -Improved clinical engagement. - Fostered local innovation e.g. Workforce. - Adopted transparent funding arrangements. - Greater public/private interaction to provide public services.
Primary Health Care Federal Government has created 61 ‘Medicare Locals’ throughout Australia – GP and other community health personnel. - In some States boundaries of Medicare Locals equate District Hospital Boards. - Joint Planning now enabled. - Some contracts evolved between DHBs and MLs re hospital avoidance/frequent flyers. - Still too early to judge overall effectiveness. - Under review.
Transparency/Performance National Health Performance Authority - Role to monitor and report on performance of public and private hospitals and Medicare Locals. - Reporting scope determined by Federal/State Health Ministers. - This year will publish first ‘poor performance’ report. - Complements actions of States in managing/monitoring performance of their hospitals.
Transparency/Pricing Independent Hospital Pricing Authority - Role is to calculate an annual National Efficient Price. - NEP determines Commonwealth funding contribution to hospitals according to hospital activity levels or block funding (for smaller hospitals). - In all States, public hospitals paid for number/mix of patients they treat. - Pricing extended from inpatient to outpatient clinics, community based clinics and inpatients homes (HITH). - Creates $ incentives for hospital avoidance, early discharge. - Greater pressure on hospitals as ‘efficient price’ more rigorously enforced.
E-Health National E-Health Transition Authority (NEHTA) owned by Federal/State governments. - Role is to develop foundations/services for national e-health capability. - Particular emphasis on creation of Personally Controlled Electronic Health Record. Designed for consumers to share health information with different providers. - Commenced 1/7/2012. An opt in system - 1.5 million Australians have joined - strong collaboration with vendors re specs/standards - not a replacement for local clinical information systems. Currently under review (opt in to opt out/greater private ‘ownership’).
Safety and Quality Australian Commission of Safety and Quality in Health Care - Coordinates national improvements in safety and quality. - Focus on clinical communications/falls prevention/health associated infection/ medication safety/open disclosure/ accreditation standards/patient experience.
Health Reform Progress Uncertainties - Health Reform initiated prior to change to conservative governments Federally and in most States. - New governments concerned with achieving balanced budgets/decreasing government outlays. - Status of Commission of Audit Report - Federal Budget.
Commission of Audit Proposals - Universal access to bulk billing (i.e. free to consumer) GP services abolished. - $5–$15 copayment on GP attendances. - Increased copayment for pharmaceuticals. - Enforcing private health insurance for high income earners. - Introduce copayment for ‘GP like’ attendances at emergency departments. - Recommends merging of a number of national health agencies on pricing, performance, quality and data collection, abolishes others. - Allow pharmacists/nurses to take broader role.
