Primary Care - Health Care Homes

Health Care Homes

The Australian Government is undertaking a broad suite of reforms in primary health care. As part of this reform process, Stage One the Health Care Homes model to improve care for patients with chronic and complex conditions has commenced.

Under the model, eligible patients will voluntarily enrol with a participating primary health care provider known as their Health Care Home. This provider will provide the patient with a ‘home base’ for ongoing coordination, management and support of their chronic condition/s.

Almost 200 general practices and Aboriginal Community Controlled Health Services around Australia have now commenced providing Health Care Home services to patients with chronic and complex conditions.

Patients who have been assessed as eligible and likely to benefit from this type of care can voluntarily enrol with a participating Health Care Home.

To enable this new model of care, payments for patients enrolled in Health Care Homes will change. Health Care Homes are paid with a monthly, bundled payment.

There are three levels of payment. The amount paid is linked to each eligible patient’s level of complexity and need, with the highest amount paid for the most complex and high-need patients.

All general practice healthcare associated with a patient’s chronic conditions, previously funded through the Medicare Benefits Schedule, will be funded through the bundled payment.

Enrolled patients can still access fee-for-service billing for care that is not associated with their chronic conditions.

Funding for services provided by allied health professionals and specialists, and for diagnostic and imaging services, are not included in the bundled payment. These services continue to be funded through the MBS. Eligibility for allied health services currently triggered by a GP Management Plan, a Health Assessment for Aboriginal and Torres Strait Islander People or a GP Mental Health Treatment Plan, will be triggered by Health Care Home enrolment.

The Health Care Home will develop a shared care plan with the patient, which will be implemented by a team of health care providers. This plan will:

  • identify the local providers best able to meet each patient’s needs,
  • coordinate care with these providers,
  • include strategies to help each patient manage their conditions and improve their quality of life.

Care will be integrated across primary and acute care as required.

Stage one of the Health Care Homes trial will run until November 2019.

Find further information at Health Care Homes—For Professionals or More Information: Health Care Homes.

Page updated 29 March 2018