General practice businesses engaged with aged care will come under greater regulation if submissions by Counsel Assisting the Royal Commission into aged care are implemented.
Indeed, the regulation maybe prohibitive for some practices who might vacate the aged-care field.
The recommendations, made at the end of October, say that by 1 January 2024, the Australian Government should implement a new voluntary primary-care model for people receiving aged care (whether in the practice or in aged-care accommodation).
Often Royal Commissions and other commissions of inquiry adopt many if not all of the recommendations of counsel assisting, so are a taste of things to come.
Counsel assisting’s aged-care recommendations say the practices would apply to become accredited aged care general practices. The initial accreditation criteria would be accreditation with the Royal Australian College of General Practitioners; participation in after-hours cooperative arrangements; and use of My Health Record. The criteria would be tightened over time.
Each accredited practice would enrol people receiving residential care or personal care at home who choose to be enrolled with that practice.
For that the practice would get an annual capitation payment for every enrolled person, based on the person’s level of assessed need.
The submissions did not say how the capitation would be calculated, who would calculate it, or whether it would be in place or in addition to Medicare payments. But it would be reduced by the value of benefits paid when an enrolled person sees a general practitioner in another practice.
The submissions said practices would agree with each enrolled person and the person’s aged care provider on how care will be provided, including by any use of telehealth services and nurse practitioners
The practices would be required to:
- meet the primary health care needs of each enrolled older person (including through any cooperative arrangements with other general practices to provide after-hours care if required)
- use My Health Record in conjunction with aged care providers
- initiate and take part in regular medication management reviews
- prepare an ‘Aged Care Plan’ (in collaboration with a geriatrician and the aged care provider and others) for each enrolled person
- accept any person who wishes to enrol with it (subject to geography) to avoid practices accepting only patients with less complex care needs, and
- report on performance against a range of performance indicators, including immunisation rates and prescribing rates
The submission also said that by 31 December 2021, the Royal Australian College of General Practitioners should amend its Standards for general practices to allow for accreditation of general practices which practise exclusively in providing primary health care to aged care recipients in residential aged care facilities and in their own homes.