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Medicare - COAG Scheme (Council of Australian Governments). Learning objectives. Understand the reasons for the development of the COAG Scheme What needs to occur to progress implementation. Background of COAG.

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Presentation Transcript

Learning objectives
Learning objectives

  • Understand the reasons for the development of the COAG Scheme

  • What needs to occur to progress implementation


Background of coag
Background of COAG

  • Meeting in February 2006 of Council of Australian Governments between the Commonwealth & State leaders

  • Discussion on practical initiatives to improve health services


Purpose
Purpose

  • The initiative will provide exemptions under section 19(2) of the Health Insurance Act 1973 to enable Medicare rebates to be claimed for state remunerated primary health care services (non-admitted and non-referred patients) in some Rural and Remote communities


Criteria for access to coag
Criteria for access to COAG

  • Population

  • Workforce issues

  • Agreed by government as in scope

  • Consent to agree with local plans

  • Funds to be used in the community

  • No threat to private practices


Negotiations
Negotiations

  • Extensive negotiations with stakeholders has occurred

  • Local flexibility with arrangements are necessary. Consideration should be given to equity between communities and parties involved.


Implementation process
Implementation Process

  • Identify site

  • Information package

  • Negotiate with all stakeholders

  • Support in writing

  • Intended enhancement to services

  • Timeframe

  • Local communication plan


Application of funds
Application of Funds

  • Funds generated must be used in communities eg

    • Support for locum cover

    • Employing additional doctors/nurses/allied health and other supporting staff

    • Chronic Disease initiatives

    • Professional development


Revenue raised
Revenue Raised

  • Not to be considered the most significant benefit

  • Some financial recognition should be given to the person/organisation doing the Medicare billing

  • Mechanisms need to be in place to oversee the use of the funds


What items can be billed
What items can be billed

  • GP type service items as per the Medicare Benefits Schedule

  • Nurse Practitioner items provided on behalf of the GP

  • Allied Health Professional items provided under Enhanced Primary Care

  • Chronic Disease and Care Planning items


Reporting
Reporting

  • Annually to the Commonwealth to indicate how much revenue was claimed and how the revenue was used to enhance primary health care in the community


Learning activity
Learning Activity

Please complete the following learning activity


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