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MBS and Community Health services Grampians Region- Industry Advisor project

Judy Perkins Primary Health Program and Service Advisor. MBS and Community Health services Grampians Region- Industry Advisor project . The challenges facing community health. A high proportion of Community Health clients have a chronic and/or complex condition

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MBS and Community Health services Grampians Region- Industry Advisor project

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  1. Judy Perkins Primary Health Program and Service Advisor MBS and Community Health servicesGrampians Region- Industry Advisor project

  2. The challenges facing community health • A high proportion of Community Health clients have a chronic and/or complex condition • Demand continues to grow for treatment and support

  3. Why - MBS Industry Advisor Diabetes Prevalence – Victoria 2001 0-2% people with diabetes   2-4% people with diabetes   4-10% people withdiabetes

  4. Diabetes Prevalence – Victoria 2008

  5. The challenges facing community health • A high proportion of Community Health clients have a chronic and/or complex condition • Demand continues to grow for treatment and support • So we need to explore other models that will support effective chronic disease care are of particular relevance to the Community Health sector.

  6. MBS and Community Health • Over the past ten years, a suite of new MBS item numbers have been introduced. The new items: • encourage a more integrated approach to health care provision • provide a catalyst for strengthening partnerships with general practice and other public and private primary health providers • provide impetus for agencies to reconfigure their services to increase client access to services, and maximise care options

  7. Examples of MBS service models Rooms for Rent • Private provider renting a room to provide a service utilising MBS • Delivery or facilitating new services • The CHS offers existing salaried practitioners the opportunity to work additional sessions as private providers within the community health setting Salaried • A CHS contracts with a private provider to work for community health who attracts the MBS income but donates 100 per cent to the community health service in return for a salary Percentage Split • Existing staff member extending hours, or entirely new provider attracting MBS and “donating” a % to CH

  8. Planning for an enhanced model of care with MBS • Establishing MBS allied health service within or alongside community health is complex. Key considerations: • Identifying current and projected client demand • Identifying referral pathways and partnerships • Which model and why • Costing the model including agreed business rules and assumptions • Risk assessment for each service model

  9. Planning for an enhanced model of care with MBS • Ensure legislative and regulatory requirements are met • Executive support • Audit of available infrastructure and staffing • Develop a recommendation on the feasibility of MBS allied health services for your Board/Executive • Ongoing project support and management

  10. MBS in Community Health project The objectives of the MBS in Community Health industry advisor project is to: Assist community health services to determine whether or not the use of MBS presents them with opportunities to enhance client access to services Support community health services in the planning for and development of new service models that incorporate MBS.

  11. Grampians Region – MBS Industry Advisor Project Aims • The Industry Advisor is available to assist community health services (CHS) to determine whether or not Medicare item numbers present them with opportunities to enhance client access to services

  12. Project progress- Phase 1: Steering Committee established with representatives from: Central Highlands PCP Beaufort and Skipton Health Service Ballarat Community Health Edenhope and District Memorial Hospital East Wimmera Health Service Ballarat and District Division of General Practice Department of Health Appointment of Industry Advisor – Peter Larter

  13. Project progress- Phase 2 • Meeting key stakeholders including CHS and the development of a regional profile • Exploration of current MBS models being utilised • Regional MBS Forum – 31st August 2011 • Collection of regional data and the development of resources to build understanding and inform decisions • Identify demand pressures and service gaps to help determine key regional priorities

  14. Project Progress – Phase 3 • Engagement with CHS who are ready and enthusiastic to continue to explore MBS models • Development of a rationale to support progressing the exploration of an MBS model of service • Development of implementation plans and to build capacity to roll out new service models

  15. Outcome • Every CHS has different priorities, capacities, cultures and interests and therefore there is no one model that will fit everyone. • Some will explore MBS models, find the right one and will develop and implement the model • Some will explore, plan and make the decision not to progress • Some will decide from the very outset that this is not appropriate for them All these can be considered successful outcomes …..because

  16. MBS project The Industry Advisor is there to assist your agency to determine whether or not the use of MBS presents them with opportunities to enhance client access to services

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