Last week's blog looked at changing transfer of care models and adapting consumer expectations and social inclusion and wellbeing. This week, Walter will sum up the blog by looking at introducing new funding models.
Introducing new funding models
There
are a number of key funding instruments, Medicare rebates for General Practitioners,
ACFI for aged care and Diagnostic Related Groups (DRGs / Casemix) for Acute
Health Services. They are performance based funding instruments. To build
health capacity they could be adapted in the case of ACFI to fund RN positions
in ageing in place services in return for the provider participating in planned
care models at point of need. Tools such as pathway mapping already exist and
have been successfully
used as evidenced by Canterbury Health Services New Zealand following the
Christchurch Earthquake.
Registered
Nurses in aged care are strong contributors to capacity. Combined with planned
events of care at point of need can reduce demand on hospital beds through
reduced transfers’ to hospital or earlier transfers’ back to residential and
community services through transitional beds with significant savings to the
community whilst improving the quality of care for recipients.
The
Australian federal government recently restructured Medicare Locals into
Primary Health Care Networks. The result has been a reduction in the overall number
of Medicare Locals and a move away from direct provision of services to
developing a framework of providers meeting the health needs of community
groups specific to their health profile and demographic. Consumers in these
networks have greater influence as to the use of funding under the auspice of
the primary health care network. These primary networks have the future
potential to be the key driver as to transfer of care models not only at point
of service such as hospitals, but more importantly at point of need such as the
persons’ home where ever that may be.
The
rate and increase of the aged population creates a strong need for alternate revenue
resources such as Social Investment Bonds as a means of funding health and
wellbeing services. Financial markets do not have a shortage of capital they
have a shortage of safe havens for capital investment. An example of a social
investment bond is Newpin
the first bond issued in Australia managed by Uniting Services. These bonds are
a future revenue stream which is performance based, subject to the rules of
commerce and investment rather than the vagaries of the political cycle.
Summary
The integration of care between
service providers is an essential element in developing the necessary solutions
to manage the health and wellbeing of an aging community. This can be achieved
when key partners reorientate in unison the physical and social infrastructure
of their services to collectively demonstrate a health gain. This strategy of
reorientating physical and social capital need only to be minor by each
stakeholder but when applied collectively has a significant local impact. The
result will free up much needed local hospital beds whilst enhancing the care
received by an aging population outside of a hospital setting. A challenge for
health and care leaders is how they demonstrate to the community a style of leadership
that brings about a whole of community response to promoting the health and
wellbeing of an aging population.
Walter will be speaking at the upcoming Transfer of Care for Complex Consumers Conference on 1-3 December. He will be a key speaker on the panel discussion discussing Complexity scales: Are they a useful tool for operational managers in transition care?
Walter will be speaking at the upcoming Transfer of Care for Complex Consumers Conference on 1-3 December. He will be a key speaker on the panel discussion discussing Complexity scales: Are they a useful tool for operational managers in transition care?
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