Halt the Hospital in the Home ‘headaches’: RACGP

The RACGP is calling on political leaders to make sweeping changes to Hospital in the Home (HITH) programs, saying they are currently hindered by red tape, administration, and billing nightmares.
 
In a letter to Federal Health and Aged Care Minister Mark Butler, the college warned the program is being held back by a lack of consistent policy and guidance.

The RACGP is calling for the Federal Government to issue clear and national rules to state and territory health departments and their hospitals about GP liaison upon patient admission, referrals, and subsequent billing practices.
 
‘This is imperative for improving clarity and consistency on the requirements, expectations and principles for funding across the general practice and hospital interface and ensuring continuity of care for all patients,’ the letter said.
 
Additionally, the college wants restrictions removed on admitted HITH patients accessing MBS services from their GP, saying the failure to support continuity and appropriate shared care is a risk to patient safety and outcomes.
 
RACGP President Dr Nicole Higgins said these growing issues are dictating how and when GPs can provide care to their patients.
 
‘The funding and cost arrangements aren’t working, so let’s change them,’ she said.
 
‘Let’s make it more straightforward for everyone by allowing patients to access Medicare rebates and GPs to co-manage their patients care.
 
‘Remember that particularly during a time of high cost-of-living pressures, concerns about cost sway many people’s decisions about the healthcare they do or don’t receive. Let’s make sure they are getting the best possible care from a GP they know and trust, it can make all the difference.’
 
The RACGP has also recommended including clinical handover requirements under MyMedicare arrangements, in which the HITH program must contact a patient’s usual GP, both on admission and discharge.
 
It likewise says GPs must be allowed to co-bill and co-manage their patients’ care.
 
The Head of General Practice and Primary Care Research at the University of Notre Dame, Professor Charlotte Hespe, told newsGP that while HITH is a much-needed addition to the healthcare system, it should not lead to patients being denied a GP.
 
‘It’s not fair for anybody, especially if the Hospital in the Home says, “go and see your GP about that”, but the patient is being denied access to affordable care or appropriate care if they can’t afford it,’ she said.
 
‘If they’re being looked after in the community, there has to be an ability for them to continue to see their GP for all their other stuff because Hospital in the Home is not designed to cover all of their healthcare needs.’
 
‘Let’s just continue to put our focus on the patient and what the patient needs to be able to access appropriate care, in the appropriate place, at the appropriate time, and Hospital in the Home is a fantastic model to do that, but not at the expense of then denying them access to their GP.’
 
In its letter, the RACGP’s examples of confusion include whether a patient requesting a routine appointment with their regular GP for diabetes management would be able to access Medicare rebates if they are enrolled in HITH for foot ulcer dressings.
 
Another example occurs in Western Australia, where hospitals request HITH patients undergo clearances and screenings performed by their GP, which could result in the GP taking a risk if they bill Medicare.
 
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general practice home care Hospital in the Home Mark Butler