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Better Outcomes through General Practice

Better Outcomes through General Practice. RHealth ATAPS Program ‘DEMAND IF DO DEMAND IF WE DON’T’. Firstly a bit about RHealth! - RHealth Service area. Area 422 325 sq km Population 177 688 (5.3% ATSI) 123 GPs 59 general practices 38 public & 4 private hospitals

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Better Outcomes through General Practice

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  1. Better Outcomes through General Practice RHealthATAPS Program‘DEMAND IF DODEMAND IF WE DON’T’

  2. Firstly a bit about RHealth!- RHealth Service area Area 422 325 sq km Population 177 688 (5.3% ATSI) 123 GPs 59 general practices 38 public & 4 private hospitals 4 Aboriginal Health Services 3 Queensland Health Service Districts

  3. Better Outcomes through General Practice RHealth Staff and Contractors 43 Staff - RHealth -19 (Toowoomba) -18 (Chinchilla, Kingaroy, Roma, Warwick) - 6 (Charleville, Tambo) 9 Staff – through Service Level Agreements with 2 Shires & QHealth (Augathella, Charleville, Cunnamulla, Morven, Thargomindah, Quilpie) 33 Contracted Allied Mental Health Professionals 31 Contracted Allied Health Professionals Total - 116

  4. RHealth Better Outcomes through General Practice Current RHealth Mental Health Programs • Mental Health Nurse Incentive Program • 1 Mental Health Nurse contracted to service South Burnett area • Mental Health Support for Drought Affected Communities Initiative • 1 Drought Support Worker employed • Mental Health Services in Rural and Remote Areas Measure • 1 Social Worker employed to provide services in areas of • Inglewood, Miles, Chinchilla and Millmerran • 5 additional AMHPs contracted to provide services • in Dirranbandi, Kilcoy, Texas, Charleville, Quilpie and Augathella • headspace Southern Downs • Office opened in Warwick with 5 staff • Services provided: youth health

  5. RHealth Better Outcomes through General Practice Current RHealth Mental Health Programs (continues) • BOIMHC / ATAPS Program General ATAPS 30 AMHPs contracted to provide services using a voucher system. Services provided in Kingaroy, Nanango, Wondai, Murgon, Cherbourg, Dalby, Tara, Miles, Mitchell, Roma, St George, Clifton, Allora, Warwick, Stanthorpe, Killarney and Beaudesert. • Telephone-Based Cognitive Therapy trial (T-CBT) • 10 AMHPs undergone training to provide services • Additional Support for Patients at Risk • of Suicide and Self Harm • Three demonstration sites set up in Warwick and Dalby/Tara • National Perinatal Depression Initiative • Additional funding received plus $10,000 core fund

  6. RHealth Better Outcomes through General Practice Current RHealth Mental Health Programs (continues) AREAS SERVICED BY RHEALTH MENTAL HEALTH PROGRAMS ATAPS program Rural & Remote Measure Mental Health Nurse Incentive headspace Southern Downs

  7. RHealth Better Outcomes through General Practice RHealth ATAPS program Snapshot of Service Delivery

  8. RHealth Better Outcomes through General Practice RHealth ATAPS program What does that tell us? • NOTHING!!! • The unpredictably of referral rates is one of the main issues when managing demand. • Reasons why:- • additional AMHPs contracted in service areas • GP engagement • practice staff engagement • availability of other local mental health providers • ‘Better Access’ Medicare Initiative • RHealth promotional activities • personalities!!! • dreaded paper work!!!

  9. RHealth Better Outcomes through General Practice RHealth ATAPS program WHAT STRATEGIES DO WE USE FOR DEMAND MANAGEMENT? Analysis referral rates for each service delivery area and use this information when allocating funds – see snapshot below

  10. RHealth Better Outcomes through General Practice RHealth ATAPS program Is this the best way to manage demand? • At the beginning of the financial year, do a funding allocation of each service delivery area based on previous year’s figures. • allocation of vouchers for that service delivery area based on last year’s figures. • Do a monthly review of referral rates and expenditure for each of those service delivery areas • reallocate vouchers based on monthly review findings • Each quarter, do a budget forecast • If financial figures are forecasting a overspend, enforce HIGH DEMAND strategies • if financial figures are forecasting a underspend, enforce LOW DEMAND strategies • OVERALL, PREPARE TO BE FLEXIBLE!

  11. RHealth Better Outcomes through General Practice RHealth ATAPS program WHAT STRATEGIES DO WE USE FOR HIGH DEMAND MANAGEMENT?

  12. RHealth Better Outcomes through General Practice RHealth ATAPS program • WHAT OTHER STRATEGIES DO WE USE FOR HIGH DEMAND MANAGEMENT? • cease promotional activities advising the benefits of the ATAPS program. • reduce communication channels with medical practices • advise GP practices of their limitations • reinforce that this program is for low income earners that can not afford the gap payment under the “BetterAccess”Medicare initiative

  13. RHealth Better Outcomes through General Practice RHealth ATAPS program • OTHER FACTORS THAT DO NOT HELP WITH HIGH DEMAND MANAGEMENT • guidelines changes • inappropriate referrals from GPs • GPs requesting additional AMHPs to be contracted

  14. RHealth Better Outcomes through General Practice RHealth ATAPS program • How do you increase demand for this program? • Promote, promote, promote!!!! • build up rapport with practice managers/nurses/staff • regularly ‘check in’ with practices

  15. RHealth Better Outcomes through General Practice RHealth ATAPS program • THE ‘BIG’ QUESTION – WHICH SERVICE MODEL WORKS BEST WITH DEMAND MANAGEMENT? • Voucher vs hourly vs employment • Benefits of using a voucher referral system • proof of actual service delivery • true measure of demand • GP feedback – like having a booklet in their rooms • patients have physical evidence of the free service • ability to be flexible in allocation of funds per service delivery area.

  16. RHealth Better Outcomes through General Practice RHealth ATAPS program • THE ‘BIG’ QUESTION – WHICH SERVICE MODEL WORKS BEST WITH DEMAND MANAGEMENT? • Voucher vs Hourly vs Employment • Benefits of using an hourly referral system • set funding allocation to each service delivery area • ability of set up services in areas previously without access to mental health professionals

  17. RHealth Better Outcomes through General Practice RHealth ATAPS program • THE ‘BIG’ QUESTION – WHICH SERVICE MODEL WORKS BEST WITH DEMAND MANAGEMENT? • Voucher vs Hourly vs Employment • Benefits of direct employment • employee is bound to internal policies and procedures • Employee is part of the team and Division culture • continuity of care for the client • cost efficient • ability of set up services in areas previously without access to mental health professionals

  18. RHealth Better Outcomes through General Practice RHealth ATAPS program • THE other ‘BIG’ QUESTION – how can we do this better? • what works? • what doesn’t work? • what is missing?

  19. RHealth Better Outcomes through General Practice RHealth ATAPS program • THE other, other ‘BIG’ QUESTION – Life after the ATAPS review • will current practices still be relevant? • funding allocation – if less, what then?

  20. RHealth Better Outcomes through General Practice Contact details  Phone 07 4638 1377 Email Mark Goddard – mark@rhealth.com.au Jennie Sealy – jennie@rhealth.com.au Web www.rhealth.com.au

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