From 1 October 2017, practice locations across Australia will commence participation in the stage one trial of Health Care Homes.
Please note: The GPRIP is subject to change by Government and it is the responsibility of eligible medical practitioners to ensure they are operating under the current version of the GPRIP Program Guidelines. No claim will be entertained for loss of payment or any other loss as a result of a medical practitioner failing to operate under the current version of the Program Guidelines.
Stage One Trial of Health Care Homes
The stage one trial was announced on 31 March 2016 in response to the recommendations in the Primary Health Care Advisory Group Report ‘Better Outcomes for People with Chronic and Complex Health Conditions’.
For more information on Health Care Homes, please visit the Health Care Homes webpage.
How will the Stage One Trial of Health Care Homes impact the GPRIP?
As the Health Care Homes model replaces fee-for-service billing with bundled payments for the management and care of enrolled patients with chronic conditions, this may result in some activity no longer being captured by the Department of Human Services (Human Services), for the purposes of GPRIP eligibility assessment and payment calculations.See the GPRIP Program Guidelines for full details.
Who will be impacted?
Medical practitioners who are participating in the stage one trial of Health Care Homes in a Modified Monash (MM) 3-7 location, and who may be eligible for a GPRIP Central Payment System (CPS) payment could be impacted.
Will medical practitioners who require assessment under the Flexible Payment System (FPS) be affected?No. Medical practitioners who require assessment under the FPS for other non-Medicare services will not be affected. From 1 July 2017, medical practitioners applying through the FPS are required to account for all time spent providing GPRIP eligible services, regardless of whether the services were Medicare Benefits Schedule (MBS) billed. This will include services to Health Care Homes patients.
Medical practitioners are required to apply directly to the Rural Workforce Agency (RWA) in the state or the Northern Territory in which they provide the majority of services, to be assessed under the FPS.
What mechanism has been put in place to ensure medical practitioners receiving CPS payments are not disadvantaged by their Health Care Homes participation?
For medical practitioners primarily billing the MBS for services and accessing GPRIP payments only through the CPS, there is a simple opt-in review mechanism available to ensure that a medical practitioner’s Health Care Home services are included in GPRIP eligibility assessments and payment calculations.
Medical practitioners can complete a simple form that self-reports the number of hours per week, on average, that they spend providing eligible primary care services from all MM 3-7 locations, across the relevant quarters. After having this form signed off by their employer or practice manager, medical practitioners will need to submit it to the Department of Health via firstname.lastname@example.org. Information provided on this form will be assessed, and if the medical practitioner is deemed eligible for a full payment or a ‘top-up’, the Department of Health will request Human Services to make a payment directly to their nominated bank account.
GPRIP - Health Care Homes Review Form
The PDF version is the recommended document for medical practitioners to download, print, complete and submit
PDF version: GPRIP - Health Care Homes Review Form (PDF 481 KB)
Word version:GPRIP - Health Care Homes Review Form (Word 37 KB)
GPRIP- Stage One Trial of Health Care Homes Information
- GPRIP - Program Guidelines from 1 October 2017
- GPRIP - Health Care Homes Factsheet
- GPRIP - Bank Details Form on the Department of Human Services Website
- Health Professional Online Services (HPOS) on the Department of Human Services Website
For enquiries relating to the impact of stage one of Health Care Homes on the GPRIP, please contact email@example.com.