Sticks and no carrots as govt pushes GPs on e-health records

THE government will bar GPs who don’t participate in the personally controlled electronic health record system from receiving e-health PIP payments, while stripping money from the existing telehealth incentive program to fund it.

Last night’s budget announcements finally answered the oft-repeated question of how the National e-Health Transition Authority would continue to function and how the PCEHR would be rolled out once the current funding for both projects expired on 30 June.

The government will spend $233.7 million on e-health over the next two years, contributing $67.4 million to NEHTA and $161.6 million to operate the PCEHR and another $4.6 million on privacy and security safeguards for the system.

But that money will come from a total of $257.5 million stripped out of the existing telehealth initiative - which will now end on 30 June next year instead of in 2015 as originally planned - and the HealthConnect program which was designed to standardise secure electronic messaging.

RACGP president Professor Claire Jackson said it was “very disappointing” to see the government using the e-health PIP as “a stick” to prod GPs into using the PCEHR.

“There’s absolutely no detail about what’s going to be available to support practices in their preparation and readiness for the PCEHR and it launches in seven weeks,” Professor Jackson told MO.

“That’s very worrying. 

“Last year general practice was mauled with the mental health cuts, this year the immunisation PIP has been cut, the cervical screening and diabetes PIP targets have been raised and the e-Health PIP has been tied to the PCEHR.

“There are a lot of sticks and very few carrots.”

Other PIP changes announced last night include increases in the cervical screening incentive target from 65% to 70% and the diabetes incentive target from 40% to 50%, while the GP Immunisation Incentives Scheme will be cut altogether, for an overall saving of $83.5 million over four years.

AMA president Dr Steve Hambleton agreed the PIP changes came “at the end of a long line of problems for general practice”.

“They dumped the rebates for GP joint injections and halved the rebate for mental health care plans,” he said.

“Now they have dumped the immunisation PIP, lifted thresholds for cervical screening and diabetes PIPs and made the e-Health PIP dependent on a practice participating in the PCEHR.”

Both Professor Jackson and Dr Hambleton said the government had not consulted the association or college on the PIP changes, which they warned would drive bulk billing rates down and lead to higher out of pocket costs for patients.