An account from Cogility partner and health practice lead, Gil Carter.
This year’s federal budget is priming the pump for an election cycle, so the focus was not on major reforms in the health sector. However, there are a number of new initiatives announced in the months leading up to the budget that were consolidated on Tuesday night, and collectively represent a gradually changing strategy for funding of health in Australia.
The establishment of the Australian Digital Health Agency (ADHA) was carried in legislation passed earlier this year, but the budget attached concrete funding levels and staffing commitments for the next year. The agency has been budgeted at $156.5M in its first year of operations, with the significant majority of this coming from Commonwealth investment. A new staffing headcount for the agency of 51 people is also noted. Ongoing operation of the newly-renamed My Health Record, and the establishment of the Australian Digital Health work programme are key focus areas, coupled with the implementation of trials sites for the ‘opt out’ model for the national electronic health records.
Another area of change is the funding of several trials of Healthcare Homes initiative. This programme supports chronic disease patients, and uses a coordinated care team model and different funding approach to support better care. Although the trials are small scale and limited locations, this model reflects a change in approach for funding primary health visit, moving away from episodic care billing that has been the hallmark of primary care for many years.
The budget reinforces funding support for the National Disability Insurance Scheme and adds significant new funding for the Aged Care call centre to handle additional volumes of traffic. One area of funding subtlety in the budget is the freeze on indexation of Medicare rebates for GP’s. The effect of this change will be to push additional operating costs for primary care into the consumer gap payment, making it gradually more expensive to see a GP and most likely reducing the number of consultations that can be bulk billed in the future.
In summary: no systemic or structural reforms in health at the commencement of a long election campaign, but a number of incremental changes that will continue to deflect the arc of health reform in Australia. Of most potential for broader future reform are the healthcare homes trials, and the potential that ADHA may offer to accelerate development and delivery of useful capabilities in connected care.