March 28, 2024

Australia: Health insurers looking into ways of working with GPs in Australia

Health funds in Australia want to pay for care given by general practitioners (GPs) to save money by keeping people with chronic illness out of hospital.One of Australia’s largest medical insurers, NIB Health Funds, which provides cover to more than 900,000 people nationwide, wants to pay GPs to provide diabetes and other chronic disease management plans. The fund is also looking at paying surgical practices whose patients do not need to stay in hospital, reported the news.com.au website.Mr Mark Fitzgibbon, NIB chief executive officer, said: “We would say to Dr Mary, you have 50 NIB members in your practice who cost us A$50,000 (US$45,435) each year, if you can reduce that cost, we’ll split the savings with you.”Doctors could also be paid by insurers to provide home visits, he said. “Inevitably, it means paying higher premiums,” he said. “But it means paying less tax because you are easing the pressure on government expenditure.”He said that Australia has to make the change if the country was to continue to be able to afford healthcare in the next three decades.The Australian Medical Association has backed the idea of working with private insurers. In a statement, AMA president Dr Steve Hambelton said: “The AMA believes it is time for the government, private health insurers and the medical profession to look at models that would support a greater role for GPs in caring for privately insured patients.”Health Minister Peter Dutton earlier this year floated the idea of a greater role for insurers in primary care.Medibank Private is already trying a pilot scheme in Queensland where it covers GP gap payments of 4,500 of its members. Medibank managing director George Saviddes said that his fund wants to pay to coordinate the GP care of the sickest three percent of its members.

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