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Medibank abandons controversial GP trial

Giant insurer Medibank Private has abandoned a controversial scheme for preferential access to GPs for its members, but is pushing ahead with a pilot program for closer collaboration with doctors in the care of patients with chronic disease.

In a discreet announcement six months after its public float, the nation’s largest health fund revealed on 22 May that it had “redefined its involvement in primary care”, and would scrap the trial of its GP Access program on 31 July.

Under the program, trialled at 26 GP clinics in Queensland for the past 18 months, Medibank members were guaranteed same-day appointments and after hours GP home visits.

It was heavily criticised by the AMA and other health groups who said it undermined the universality of care and the principle that patients should be treated on the basis of need rather than income or affiliation.

Announcing the decision, the insurer’s Executive General Manager, Provider Networks and Integrated Care, Dr Andrew Wilson, said that although the 13,000 members who had used the service were pleased with it, “they did not feel it added additional value to their private health insurance”.

Dr Wilson said the fierce reaction of the AMA and other groups had also weighed on the decision to scrap the program.

“Disappointingly, it was clear from the feedback that this pilot was perceived as a first step towards the creation of a two-tier or exclusive health system,” he said. “Medibank is a strong supporter of universal health care, and we would certainly hate people to think that we were trying to do anything like this.”

Instead, the insurer is turning its focus to a scheme for closer collaboration with GPs in caring for members with chronic and complex conditions.

Last September it launched a pilot of its CareFirst chronic disease management scheme at six clinics in south-east Queensland, under which GPs receive payments to enrol patients with chronic health problems including heart failure, COPD, osteoarthritis and diabetes into a program that includes a care plan, health coaching and online education. Doctors are awarded incentives for improvements in patient health.

Medibank said that so far more than 200 patients had been enrolled, and early results were promising.

“Stakeholders also told us that GPs feel stretched and unable to provide the longitudinal care they’d like to be able to provide their patients battling chronic illnesses and complex health issues,” Dr Wilson said. “Through both our CareFirst and Care Point pilots we are now working closely with GPs so they can do more for their patients, particularly in tackling chronic disease and keeping people out of hospital.”

Adrian Rollins