Consumer Directed Care or CDC is the new buzz phrase in the subsidised government care of our elderly patients.
Once fully established, it will potentially place the GP/patient relationship in the centre of a range of care decisions and will present opportunities for practices that are pro-active and embrace these changes.
The intent of CDC is to put the control over how to spend government funds into the hands of patients, their family and carers. In other words: the consumer. This contrasts greatly with how the system has previously operated, where the money was placed in the control of homecare package providers. For years, these package providers have managed the money on behalf of the patient.
The inefficiencies in the system up to now have been widely recognised and it seems that the person who has lost out the most is the patient. Historically, significant amounts of government dollars have been consumed in wasteful administrative fees. Much of what is left goes to pay agency fees for care workers, and in many cases, those care workers are being billed out by the same ‘not for profits’ who are controlling the purse strings in the first place. GP’s have not had a significant role and have not historically been seen as a reference point in this care.
From 1st July 2015, new legislation came into play. This constitutes the first stage in handing the dollars, the control, the power and the choice to the consumer. The plan is that, by 2017, a mechanism will be in place that gives control of the dollars to the consumer.
From then on, service providers will vie with one another to entice the consumer. The idea being that the providers will innovate and offer services more relevant to consumers, the overall marketplace will become more efficient, fees for care services will be more competitive, and administration fees will be reduced – with the end result being that the vulnerable in our society will access more hours of care and services for the same government dollar.
As well as being of great benefit to the consumer, this presents a significant opportunity for GPs to play a greater and central role in the care choices that their elderly patients make.
During this current transitionary period, while moving toward full implementation of CDC in 2017, the home care package service providers still hold the funds and administer the package. But, following the changes that became effective as of 1 July 2015, package holders are obliged to provide consumers with wider choice, and a greater ability to direct how their package dollars are spent. They are also required to put much greater emphasis on wellness and reablement strategies into the services they offer.
So what does this mean right now for patients and their carers living at home and using government funded homecare packages?
Right now, it means that the consumer has more say in the kind of services they access, so they can get the greatest benefit from their package. For some it might mean more support in the home with domestic and personal care; for others, it might mean social outings, group exercise programs, or a walk on the beach; for another, a new wheelchair – whatever is appropriate to their individual needs, the consumer now has more influence over how their package dollar is spent.
They can also choose the service providers that are used. They can even outsource the case management role away from the package holder to specialist case management organisations who can advocate on their behalf to ensure they get the best value from their package.
Further changes will be implemented in 2017 and the consumer will be looking for guidance from a trusted source on how to access the best and most effective care.
The patient’s GP is especially well placed to fill that role. Forward looking GP clinics are already looking to partner with new organisations who understand CDC and who know how to make it work better for the consumer.
Article written by Brendan Browner from National Care Management.
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