PMP Briefing Session - Hospital Authority

PMP Briefing Session

Thank you for attending!

Time Item Presenter

1:30 – 1:35pm Welcoming remarks Dr K M CHOY

1:35 – 2:00pm Programme details Dr Leo CHAN

2:00 – 2:15pm IT support Eric HO

2:15 – 3:00pm Q&A session

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“45元睇私家醫生”

“Welcome step to ease care burden”

“六千人受惠”

“以公立醫院協議價格訂購藥物”

“三區推公私營協作”

Background

*

^

#

2011 Population Census, Census & Statistics Department.

Hospital Authority Annual Report 2012-2013, Hospital Authority

Hospital Authority Strategic Plan 2012-2017, Hospital Authority

Hong Kong Population* 3 Districts Population* HA GOPC Attendance in 12/13^

7Mn 1.5Mn 5.6Mn

43 %

Patients have Diabetes Mellitus /

Hypertension#

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Programme Components

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Subsidy Enhanced IT Support

Improved Drug logistics and

management Strong

Cluster Support

Patients & Service Providers

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Target Patients Service Providers

General Outpatient Clinic (GOPC)

Patients

– Hypertension ± Hyperlipidemia

– Incl. Diabetes Mellitus later

– Clinically stable

– Having stayed in HA GOPCs for

12 months by the time they start

service under GOPC PPP

Private Medical Practitioners (PMP)

– Registered Doctors under the

Medical Council of Hong Kong

(MCHK)

– Practising in pilot districts

– Service hours requirement (At least 5 days per week for 3 hours per day)#

# Including sessions by their relieving doctor attending their clinics and providing services in their place

Patient

Programme

Subsidy

(fixed)

PMP

2-way sharing of clinical information

Patient to

pay

prevailing

HA Fee

Doctor

Consultation Drugs Investigations

Service Package

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Patient Journey

Programme Fee

• Principles

– Patients to pay same fee as for HA GOPC

– CSSA and/or waiver patients enjoy the same

fee waiving arrangements as in HA

– HA to pay PMPs the balance or any amount

being waived

– Electronic reimbursement to PMPs 9

Service Package

• Doctor Consultation

– Up to 10 consultations per year

– Covering chronic and acute care

– At least one chronic consultation every 12 weeks*

10 *

Hong Kong Reference Framework for Hypertension Care for Adults in Primary Care Settings, Primary Care Office, HKSAR Government

Programme Fee

• Remarks

– Per mutual agreement, patients may receive further

services and treatment provided by PMPs at their

own expenses outside the Programme

– Those aged ≥70 can pay for non-Programme

services by Health Care Vouchers, as appropriate.

Annual voucher amount will be $2,000 in 2014/15

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Preparation Fee

• To cater for abortive work due to patient’s

defaulted 1st appointment (incl. review of patient’s clinical

information + drugs arrangements + blocked appointment slot)

• One-off for each newly enrolled patient

• To be off-set against the reimbursement for

the patient’s 1st chronic consultation

• $185*/ Patient (= fee for one chronic visit)

12 * With reference to the Fee Survey findings (Consultation Fee for Chronic care)

Programme Fee

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A. Each Clinical Consultation : $235

– Reimbursed monthly

B. Drugs & Additional Clinic Operations :

$89.5/ Quarter

$235 x 10 $89.5 x 4 $2,708/patient/Year

To Summarize Price Level per year

(computation formula)

Elements $ Frequency Total

Amount

Chronic

Consultation

$320^ 4 $1,280

Acute

Consultation

$238* 6

(maximum)

$1,428

Annual TOTAL $2,708

Payment to PMPs per year

(maximum reimbursement)

Elements $ Frequency Total Amount

Chronic Consultation $235

4

6 $2,350

Acute Consultation

Drugs + Additional Clinic

Operation Fee $89.5 4 $358

Annual TOTAL $2,708

^

*

Incl. the averaged amount of annual cost for chronic drugs ($332) and additional clinic operation fee ($208)

Incl. the averaged amount of annual cost for 1 course of Antibiotics ($18) 14

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470,800

4,708

[per year]

2,000 2,708 4,708

Service Package

• Drugs

– Chronic drugs and up to 3-day episodic drugs ±

1 course of Antibiotics, if necessary

– PMP may use own drugs or purchase specified

Programme Drugs from HA’s Suppliers at GOPC

Programme Price

– Quantity tiering + capping as appropriate

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Anti-HT Lipid-lowering Antibiotics

Lisinopril

Losartan

Perindopril

Atenolol

Metoprolol

Propranolol

Amlodipine

Nifedipine SR

Amiloride / Hydrochlorothiazide

Indapamide

Triamterene / Hydrochlorothiazide

Simvastatin

Amoxycillin / Clavulanic Acid

Ciprofloxacin

Clarithromycin

Supplementary to anti-HT Anti-Diabetic

Aspirin

Prazosin

Potassium Chloride SR

Terazosin

Gliclazide

Metformin

Programme Drugs

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IT Support

• Crucial for continuity of care

• Patients + PMPs will join PPI-ePR / eHR

• Convenient IT platform

– Clinical documentation

– Payment arrangements

• High priority in eHR rollout in 2014/15

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Service Package: Cluster

Support

• Specified investigation

– PMPs can request via IT platform

– Patients can have tests at HA clinics

– Results/ reports auto-sent to requesting PMPs

for necessary follow-ups

• RAMP

• SOPC / other referral 19

Key Support

• Cluster Help Desk

– Designated registered nurses

– Help enroll patients to PMPs

– Provide clinical/ logistic support

– Assist referral to HA for specialist care, if needed

– Revert patients to HA, if necessary

• Hotline for enquiries

• Training sessions on the IT platform

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Stakeholders Engagement

• Extensive consultations

with doctors in the pilot districts

• Key comments

– Generally positive

– Programme can benefit patients/ public at large

– Support in principle

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Community Engagement

• Supported at Tuen Mun and Wong Tai Sin District Councils (DC) on 11 March 2014

• Key comments – Support and welcome the Programme

– Consider the Programme helpful in managing demand on the public sector thru’ leveraging on capacity and capability of the private sector

– Surveyed local residents positive

– Hoped Programme will increase patient numbers / diseases covered

• Invited to Kwun Tong DC on 8 April 22

Initial Programme Implementation

• 3 Pilot districts

– Kwun Tong

– Wong Tai Sin

– Tuen Mun

• Initial planning target = 2,000/ district (i.e. total 6,000 patients)

• Subject to response, will consider expanding

the scope in terms of number of patients /

districts / diseases

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PMP Invitation

• Invitation package sent out on 21 March 2014 – Invitation letter

– Terms and Conditions

– Enrolment form

– PPI-ePR application form

– Request form for pricing info

– Bank auto-payment form

• On-going, individual PMP-based enrolment

• If enroll by 11th April, your name can be included in the 1st doctor list, which will be sent out to patients around mid 2014

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Thank you for your support to

your community

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Patient To find the Programme

attractive and affordable

Can benefit from private

medical services

PMP To find the Programme

acceptable

Able to further contribute

to the public at large

Healthcare System Able to help address the

public-private imbalance with

the sizable number of patients

being diverted from public to

the private sector

IT Platform

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Q&A Session

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Thank you

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