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Chronic Health Changes

Discussion in 'Australia' started by toughspiders, Mar 31, 2016.

  1. toughspiders

    toughspiders Active Member

    Members do not see these Ads. Sign Up.
    Hi, i guess most of you have heard the news today about changes to Chronic Health. Does anyone know what, if any impact it has on us Pods?
  2. trevor

    trevor Active Member

    I believe this is where the GP is paid a fee by the government to provide a total care package for the patient. The GP pays the podiatrist.
  3. trevor

    trevor Active Member

  4. Tim Foran

    Tim Foran Active Member

    So I can only imagine that GP's will only want to pass on the minimum amount to podiatrists in regards to payment. We will quickly find out how much they really think we are worth. What a great idea!!!
  5. surfboy

    surfboy Active Member

    The establishment of "health care homes" and the "move away from fee for service model". - Scary stuff for Podiatrists.
    The "health care home" will probably want to employ a salaried Podiatrist with no scope for fee for service.
    Also - "quarterly payments" ?! - My mortgage won't withstand this.
    We need to lobby to stop this !!!
  6. surfboy

    surfboy Active Member

    The government could easily walk all over us with this initiative because:

    1. The allied health lobby is nowhere near as strong as that of the AMA.
    2. This initiative not only saves the government money, but is actually also in favour of Doctors (and thus the AMA) whom will ultimately control the care coordination and allocation of funds.
  7. LuckyLisfranc

    LuckyLisfranc Well-Known Member

    This is the beginning of the end for fee-for-service podiatry under Medicare, and the EPC program in general. Unfortunately in this time of fiscal tightening, the EPC program is low hanging fruit for the Feds. We are now about to move into the UK model of GP fundholding. Interestingly, there is an imminent threat that we will also lose our national board and be merged in with a bunch of other nonmedical groups, like the UK - coincidence? Heaven help any practices that rely on a heavy percentage of Medicare patients.
  8. trevor

    trevor Active Member

    GPs have been working on this model for a number of years.
    My own GP discussed it with me about 5 years ago and was quite confident that it was about to be introduced then. It was during the Howard years I believe. So I suspect this explains the delay.
  9. surfboy

    surfboy Active Member

    Agreed, guys.

    Podiatry alongside Physiotherapy utilises the vast majority of Medicare CDM claiming.

    Absolutely, heaven help any Podiatry practice with a large Medicare workload (indeed, this is the majority of practices).

    The reality is though, that we are only a small profession. As a result of our small profession and the high demand for our services, there is real scope to lobby to ensure that our services continue through Medicare. It would be disastrous to have GP's dictate what our rate of payment will be for services provided. Without effective lobbying though we are doomed.

    I mean for goodness sake, a GP is paid approximately $240 for combined items 721 and 723 in the current team care coordination payments for CDM plans. - MAYBE it would make more sense to simply reduce this atrociously high fee that GPs are paid, surely this alone would save millions of dollars a year!!!:eek:

    Attached Files:

  10. LuckyLisfranc

    LuckyLisfranc Well-Known Member

    Unfortunately this is the business model for the majority of corporate GP clinics. GP fundholding will only see a greater proportion of $ going into care "coordination". Good time to buy shares in Healthscope or Primary me thinks.
  11. toughspiders

    toughspiders Active Member

    I think most allied health professionals would welcome a change at least one that allows and compensates for a larger scope of practice. The proposal you pasted Trevor (thank you) makes very little sense, which to me means usual Politiicans spin "let's just see if we can save money" . It has little to do with patients and an increased level of care. I have failed to see a patient who has had numerous GPs over the span of a Care Plan! Purely I feel this is adrive for reducing government costs and a commitment to GPs to offer them an incentive to keep their patients! Keeping the both happy whilst stuffing is allied health
  12. toughspiders

    toughspiders Active Member

    Oh and I would dearly have liked to have seen something from our Socieities prior to this release, again we are in reactive rather than proactive
  13. surfboy

    surfboy Active Member

    APODC do you have any comment ?
  14. APodC

    APodC Active Member

    Hi all,

    The APodC has certainly been involved in the Healthier Medicare Review since the Minister for Health, Sussan Ley, announced it in December 2014.

    Our team has represented podiatrists at roundtable discussions facilitated by the Primary Health Care Advisory Group (which was responsible for the Report). We've engaged with all related government consultations and calls for submissions. I have personally met with both Minister Ley, her shadow Catherine King, and Greens leader Richard di Natale on multiple occasions to raise our concerns about the role of podiatrists (clinical and otherwise) under this possible new funding model.

    Furthermore, the integral role the APodC plays in both Allied Health Professionals Australia (AHPA) and the National Primary Health Care Partnership (NPHCP) means the needs of podiatrists are also addressed whenever the profession-wide Allied Health representative groups communicate with MPs or policymakers.

    The APodC has kept the public updated throughout the consultation process through its online media channels. You may like to view our Facebook post of 15 December 2015 (https://www.facebook.com/permalink....383715&notif_t=like&notif_id=1450141302006858) where we informed followers that impending changes were likely. Obviously the Primary Health Care Advisory Group's final report to Minister Ley was confidential and the APodC could not comment on its final contents prior to its public release last week.

    I wish to make clear that media reports suggesting the funding-holding Health Care Homes will be managed by GPs are by no means confirmed. I've received assurances from the Minister's office this week that these details are yet to be worked out. At this stage, all that has been confirmed is a broad acceptance by the current government of the Report's principles.

    The APodC and, indeed, all Allied Health representative organisations have been steadfast in our contention that clinical practitioners, including GPs, not have any control over the distribution of funds. We have been patently clear in our argument that if funds for Allied Health services are given to GPs they will be siphoned off to employ practice nurses and boost the GPs bottom line. We've witnessed this time and time again and have explained our concerns consistently throughout the Review process. Whether or not we are successful in our demands is ultimately in the hands of government decision makers.

    Members of the Australian Podiatry Associations have been kept informed along the way particularly through the Australian Podiatrist magazine. It is disingenuous for those podiatrists who elect not to become members of our professional body to criticise the work of the APodC, only to express disappointment or surprise when they are not prepared for policy changes.

    If you wish to be updated consistently on changes with the potential to affect podiatry professionals, you are more than welcome to become a member in your state.

    Damian Mitsch, CEO APodC
  15. toughspiders

    toughspiders Active Member

    Thank you for your reply APODC. Please do not make off the cuff remarks about people criticising you, not being members! as indeed i am and have been since i started practicing. I also have a right to comment and pay heavily to do so. I am also not being disingenous. Incidentally i have gone through the last magazine and on there is no facebook symbol indicating that there is such a page to like! There is a small article in the magazine about changes to the National Disease strategy but it does not go into detail and i found that i learned more from this page and the new articles in the press about how it is likely to look.
  16. APodC

    APodC Active Member

    Thanks Toughspiders. As I said in the previous post, until last week the report was confidential and was on the Ministers desk. The media reports are at this stage speculation from journos and others as the ministers office hasn't confirmed what the model will look like - to quote the ministers office "the first 12 months will be very much about building the model".

    We did comment on Facebook on the day it was announced but when we go to members with details, it'll be accurate information from the Minister or the Department about how it will impact members. We won't speculate, react to hype or provide misinformation. We are however advocating strongly around what we believe will help or hinder better access to podiatry services.
  17. toughspiders

    toughspiders Active Member

    I have a right to comment and criticise as i pay heavily to do so and have for many many years... The changes and its possible affects should be front page of the magazine. It has implications to the majority of practising Podiatrists. I note a "small article in Feb/March" issue but it doesn't explain how it will affect Podiatrists. It appears from the media that there is a good idea of how this will work. It sounds like the trials will be starting soon.
  18. toughspiders

    toughspiders Active Member

    whoops sorry about that comment twice,, computer hiccups
  19. toughspiders

    toughspiders Active Member

    APodc thank you for that, i think i would have been happy to learn that those details are confidential and that you do not know as yet.
  20. jos

    jos Active Member

    Well, I just find it ludicrous that GPs would be in charge of distributing payments when they can't even get the referral process correct after all these years.
  21. surfboy

    surfboy Active Member

    Thanks APODC.
    Yes you are absolutely correct, if the GP practices act as fundholders, the money will simply be siphoned off to employ practice nurses and improve their bottom line.
    Going off track a little, but being such a small profession with highly specialised skills there is real scope for us to break away from the label of "allied health", much alike dental practitioners.. Why this has not happened yet is beyond me... We as Podiatrists always seem to be at the mercy of the Government and GPs
  22. trevor

    trevor Active Member

    Interestingly there were several press releases on 31 March from the ministers office.
    If you read them you will notice that none of them mention the word " podiatry "
    They mention other allied health professions by name but not podiatrists. Perhaps this tells us something about the podiatry profile.
    Something else you might notice is that the allied health professions that are mentioned are referred to as " Specialists" However if a podiatrist was to call themselves a foot specialist they would be in BIG trouble with AHPRA ..
  23. surfboy

    surfboy Active Member

    Agreed Trevor - I also noticed that not once was the word "Podiatry" mentioned in any of the ministerial press releases.

    This is highly unusual especially given that Podiatry is one of the biggest consumers of the Medicare CDM program.
  24. Tim Foran

    Tim Foran Active Member

  25. APodC

    APodC Active Member


  26. markjohconley

    markjohconley Well-Known Member

    How so, anyone?
  27. APodC

    APodC Active Member

  28. Tim Foran

    Tim Foran Active Member

    What is Labor's policy on EPC's. Will they continue the move away from the current model?
  29. podclinicmanager

    podclinicmanager Welcome New Poster

    I for one think this is a very serious change. Do not be deceived about this. THIS IS SERIOUS and will affect every single business. Do you think patients are going to come because they LOVE you or because they CAN SAVE. Any clinic stating I DO NOT NEED EPC is a fooling themselves. The government wants to control and so do GP's through the AMA. And now this is the final hurdle being taken away from us.

    This will spell the end for many clinics as we know them today. Wages will decrease. Do you think HOME BASE clinics are going to pay you $53 per patient? NO WAY! Many pods are already being screwed over by high rents or a huge percentage of the fee take.

    GP's will DIVERT the Government funds to their own NURSES delivering CARE. Yeah right on!

    Talk leads to action and there is BILLIONS to save here. and Podiatry and Physio will lose out big time. Think seriously, do most of your patients REALLY need you? Think hard on that one. Do they? probably they could do a lot themselves or a relative or a nurse. CHECKING and looking at the SCIENCE is not what patients think of. Nor do GP's.

    As a poster stated here EPC care plans are BIG BUSINESS for most GP clinics and this way the government can cut down funding for all services. Do they care about reading your EPC letters and reports? I would think 5% may.

    This is a very big change and a decrease in the recognition of the services and work Podiatry and Physios provide in chronic care. It will mean a great loss of income too.

    I would also think the software companies out there will be shivering because they will lose out on many allied health professionals using systems now because these people will be out of business or slaving away for peanuts in a GP HOME BASE clinic. Supercentres - controlled by corporations focused on profit not care.
  30. podclinicmanager

    podclinicmanager Welcome New Poster

    This is nice BUT it does not state they will keep the EPC program or REMOVE the HOME BASE care model does it? Just more whitewash to keep the plebs controlled.

    Labor is also a GOVERNMENT contender. If they can SAVE they will. Sure restore the indexation EASY but use a calculator.

    HOME BASE model save billions and indexations costs millions over 10 years. Hmmmm what to do? What to do the new health minister says.

    And we all lose. APODC you need to do better than rubber stamp and shake hands and say we will get back to our members on this one.

    If this comes in you will be of no consequence and your jobs gone too. This could see the diminishing of all ALLIED HEALTH services as we know them today and NEXT year is not far away
  31. APodC

    APodC Active Member

    Hi Podclinic, if you're an APodA member give me a call. I suspect I can give you a better run down directly than posting. The last thing we're doing is shaking hands and rubber stamping, if we were then the Podiatry Board of Australia would currently be in the process of being merged with other professions. Equally however, we'd be silly to pass on verbal statements from the Ministers office until we see ink on the page. Till then, we'll keep fighting for members.

  32. LuckyLisfranc

    LuckyLisfranc Well-Known Member

    Here is the Greens proposal:

    (Source: Australian Doctor)

    Most of the proposals that are floating around centre on GP Fundholding. This is the real danger.

    If they do bother to engage AHPs for their patients at all (why would they?) - then they will find the cheapest option. ie employ a salaried part-time podiatrist, most likely a new graduate on the cheapest hourly rate possible. Goodbye to incomes for established practices.

  33. LuckyLisfranc

    LuckyLisfranc Well-Known Member

    The aforementioned report is now available: Report on the Inquiry into Chronic Disease Prevention and Management in Primary Health Care.

    Most interestingly, are a couple of the recommendations:

    Now doubt a report that will be buried and not get much traction in election phase.

    Would love to see APodC pressure the Minister and Opposition health spokesperson for comment on implementing these recommendations prior to the election so this can be passed on to members.

  34. surfboy

    surfboy Active Member

    This matter is VERY SERIOUS INDEED.

    Many thanks to the above posters, including Luckylisfranc and Podclinicmanager.

    Podclinicmanager is exactly correct. Whoever says that Medicare CDM plans do not form a significant part of their practice workload, is kidding themselves.

    We as Podiatrists could be absolutely decimated by any change or restriction to the Medicare CDM program. It is all to do with the demographic that we service. Elderly pensioners, the disabled, SIMPLY DO NOT HAVE ENOUGH MONEY TO PAY FOR PODIATRY WITHOUT THE CDM PROGRAM.

    Physiotherapy would probably be less implicated, as they service a much winder age demographic. They are primarily dealing with patients whom are active and work, and thus able to afford to pay without CDM program assistance. Physio's also do A LOT of workcover claims as well.

    At my busiest Podiatry clinic, I deal primarily with aged pensioners and the disabled. If the CDM program was taken away, my business would collapse.

    Another poster here was spot on by saying that the new "health care homes" will no doubt look to cut costs at EVERY OPPORTUNITY. The model will be to employ a part-time Podiatrist on some atrocious hourly rate.

    This is an emergency for Podiatry, as our patients are massive consumers of the Medicare CDM program. Without the Medicare CDM program, we could literally see the collapse of Podiatry practices overnight.

  35. APodC

    APodC Active Member

  36. surfboy

    surfboy Active Member

  37. APodC

    APodC Active Member

  38. surfboy

    surfboy Active Member

    This whole thing with the changes is a real worry.

    If the GP's do get the responsibility of fund holding, it will absolutely decimate the Podiatry profession.

    It's bad enough already with nursing homes nationally giving their Podiatry service contracts to these Podiatry "companies", which employ salaried Podiatrists on an absolute pittance. - Any negative change to the Medicare CDM program will only further damage our profession's standing.
  39. surfboy

    surfboy Active Member

    APODC, do you have any advice as to whom we should vote for as a collective at the forthcoming election as a result of these proposed changes???
  40. trevor

    trevor Active Member

    The original EPC program was put in place by the democrats way back when they held the balance of power in the senate and was paid for by and part of the sale of Telstra. If I remember correctly.
    So what are they going to sell and who will be our shining knight this time.

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