Factors that affect the amount paid to practices
The amount a practice receives depends on the following factors:
- size of the practice
- type of eligible health professionals engaged
- average number of hours health professionals work per week
- type of practice
- location of the practice.
See the WIP Practice Stream Guidelines for detailed explanations and examples of incentive calculations.
The following is a general overview of the factors that affect practice payments.
Practice size
Services Australia calculates the practice size using a measurement called the Standardised Whole Patient Equivalent (SWPE). The SWPE value is based on the Medicare Benefits Schedule (MBS) billed care that is provided by all general practitioners within a practice.
If practices do not have an established SWPE value with Services Australia, they will receive Practice Stream payments at the 1,000 SWPE level until their true value is established. This process takes about 18 months.
The maximum incentive is capped at 4,000 SWPE.
Practices may not receive the maximum incentive payment because they:
- are smaller (with less than 5 full-time general practitioners engaged in the practice)
- engage health professionals for less than the minimum hours required
- engage health professionals with a lower incentive payment.
Type of professionals engaged and hours worked
Practices must confirm the type of health professionals they engage, and the hours they work per week on average, each quarter. Different incentive amounts apply to different health professionals (see Table 1). To qualify for the maximum incentive, a minimum number of engagement hours per week apply.
| SWPE | Minimum average number of hours per week for full incentive payment | Annual incentive amount for a nurse practitioner, registered nurse or allied health professional | Annual incentive amount for an enrolled nurse, Aboriginal and Torres Strait Islander health worker, or Aboriginal and Torres Strait Islander health practitioner |
|---|---|---|---|
| 1,000 | 12 hours 40 minutes | $32,500 | $16,250 |
| 2,000 | 25 hours 20 minutes | $65,000 | $32,500 |
| 3,000 | 38 hours | $97,500 | $48,750 |
| 4,000 | 50 hours 40 minutes | $130,000 | $65,000 |
|
Loadings
Extra loadings apply for practices that are:
- in rural areas, defined as Modified Monash Model classifications MM 3 to MM 7
- Aboriginal Medical Services and Aboriginal Community Controlled Health Services
- providing general practitioner (GP) services to Department of Veterans’ Affairs (DVA) Gold Card holders.
Rural loading
Rural practices receive a loading, on top of the Practice Stream incentive payment, in recognition of the difficulties they face in attracting and retaining health professionals. Loadings are expressed as percentages of the calculated quarterly payment for that practice.
We use the Modified Monash Model 2019 classifications to calculate loadings for geographic zones. Practices in MM 3 to 7 locations are eligible for rural loadings set out in Table 2.
| Modified Monash Model 2019 | Rural loading |
|---|---|
| MM 3 | 30% |
| MM 4 | 40% |
| MM 5 | 40% |
| MM 6 | 60% |
| MM 7 | 60% |
Increased SWPE value for Aboriginal services
Aboriginal Medical Services and Aboriginal Community Controlled Health Services receive an increase of 50% in their SWPE value.
DVA loading
Practices which receive Practice Stream payments and provide GP services to DVA Gold Card holders are eligible for an annual payment for each veteran. Services Australia will identify these practices and make payments once a year in the August quarter.
Resources
Workforce Incentive Program Practice Stream Guidelines
