Call for outcome-based funding

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Funding for community pharmacy should not just be based on activity but on outcomes or bundled services for chronic care, says Guild leader

The future that the Guild envisages for community pharmacy includes funding based on outcomes or bundles of services, says Anthony Tassone, President of the Pharmacy Guild of Australia (Victorian Branch).

This is opposed to activity-based funding, which forms some of the basis of the current community pharmacy model.

“There’s been a lot of resistance from doctor’s groups around Health Care Homes because they’ve got their own model that they prefer called a Medical Home, which is fundamentally a block payment for the delivery of bundled services to chronic care and complex patients,” explained Mr Tassone at a panel session held at PSA18 conference last week.

“Pharmacy can play a role in delivery of services for that, whether that’s DAA packing, medication management plan formulation and medication reconciliation and other similar services.

“In the future what we envisage to see with community pharmacy – and in general practice as well – is not just funding based on activity, it’s funding based on outcomes, or funding based on a bundle of services.

“It’s a lot of what we’re already doing as a sector, but it’s about bundling it together as a chronic care package.”

Mr Tassone referred to the Victorian Chronic Disease Management pilot, which commenced in September last year.

The 18-month pilot across four sites includes a pharmacist collaborative prescribing model with general practices, regarding four disease states: antihypertensives, anticholesterol agents, anticoagulants and asthma medications.

“Under a GP-led plan, pharmacists can dose titrate, do interventions between GP appointments, and other disease management services … so that patients are getting quality chronic disease management in between their GP appointments. So we look forward to reporting back [on that],” he said.

PSA president Dr Shane Jackson also called for pharmacists to be involved in GP-led chronic disease management, with a push for them to be eligible for MBS subsidies as part of this care.

“I have written numerous letters to the Medicare Taskforce Review, had a number of meetings with department people and with politicians about access for pharmacists to be able to participate in consultations under the chronic disease management items,” said Dr Jackson.

“Pharmacists are the only AHPRA-registered healthcare professionals who are unable to be referred to and reimbursed on the MBS for these chronic disease management consultations.

“All we’re asking is for pharmacists to be added to the list so that the general practitioner can choose to include them in the team for that person with chronic disease. This decision would go a long way in supporting that integration.”

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