Australia’s mental health care system I struggle to cope With demand. But it doesn’t mean that more money must be treated for everyone.
We are an overview Investigate this weekWe need to provide incentives for medical service providers to improve the results to pay more results.
Lee’s research that the Australian government funded funds National Mental Health CommitteeIt briefly explains why such reforms and how it works.
Problem of mental health
Many Australians with mental illness health cannot access treatment when needed due to long waiting lists and high patient costs.
Nearly two -thirds are waiting for 12 weeks or more Caring for mental health. About 1 out of 5 have been reported expense It was a reason why I didn’t delay or see mental health experts.
Even if people are approaching, this is not often based on evidence, so it is likely to be rapid. For example almost Half of all meetings Treating depression is inappropriate and consequently considered low value.
Individual management paths are also intervals. For example, some people who attended the hospital after suicide attempts may not be able to manage mental health when they leave. People find that it is difficult to explore mental health care services in the community. In other words, people may have a crack and do not receive the necessary treatment.
As a result, we waste valuable medical system resources instead of community -based treatment, which is low in health and expensive acute inpatient patients.
How can we change?
One of the reasons why mental health care struggles to meet the needs of the patient is because of the way the health care funds are raised. Medicare pays a commission to a service provider based on the MEDICARE benefit schedule (MBS).
MBS is paid according to each service provided by the provider, so it encourages more services to the provider. This commission model does not encourage the supplier to provide quality treatment or to improve health results efficiently.
Therefore, we must reform how mental health care raises funds, including the good treatment costs that provide the results of the patient.
All Australian governments have We agreed to reform health careTo start paying value and results.
The implementation began, but it is slower than expected. The government also tries to shift GP funds into a payment model that mixes Medicare with other payment types such as value -based payments.
How do we pay for good value management?
Our research explored how to use value -based payments to make more value for mental health care funds.
We interviewed the state, territory and federal government departments and institutions and held several national workshops with providers, caregivers, caregivers, peak or scholars.
Depending on the value -based payment model, doctors, psychologists and psychiatrists will receive more funds if they provide better treatment. We cannot rule out some of the money to avoid the agreement goal, which may be controversial.
These financial incentives will encourage providers to invest in time and effort to improve treatment, technology and patient experience.
The measured results are evaluated by patients, such as more competent social interactions and improving the ability to function at work. This requires a change in suppliers’ accidents, mainly trying to improve clinical results. Our counseling does not always match the value of the patient.
Incentives can be used for individual practitioners, multi -field teams or practices. Value -based payments can collect a variety of health services to provide treatment that focuses on patients’ needs and preferences. This can generally contain physical and mental health services, given the person who imports the other.
Value -based payments can also be used to bind mental health services with non -health services that affect mental health results such as social welfare, housing, education and judicial services. This bundle of treatment aims to treat patients while dealing with the root cause of mental health.
How do you know that this works?
There was an agreement between respondents to use the value -based payment model in the Australian mental health care system. Unfortunately, there are few evidence of how to better structure it.
New evidence Compared to the use of the fee model, it shows that if you pay more to the provider to provide better quality control, you will have advantages. However, some exams did not improve the results.
According to our study, we need to know more about the size of incentives, whether it should be targeted for individual practitioners, teams, or practices, the results we need to measure, and the goals that the provider must achieve.
This evidence can only be collected through a random controlled test conducted in the Australian health care system and is implemented in time and in other environments over time. We must learn from the success and failure of this test.
Overcoming barriers
Reforming mental health care for value -based payment will be complicated and difficult.
Respondents identified the barriers, including:
- Define important results for patients
- There is no evidence of how to improve the results of value -based payment
- Resolution of the gap in manpower
- Explore political complexity and procedural tasks
- It deals with reform costs.
The provider needs to change the business model and the government must invest much more in data collection and data infrastructure.
What should happen next time?
The government should better define what value means in mental health care and establish integrated consensus results. We need to raise the provider awareness of the need for value -based payment and develop a 10 -year strategy and implementation plan.
For the next four years, the government needs to develop and implement mental health data infrastructure strategies to fill the data gap. Mental health care reforms must be integrated into the continuous payment reform of hospitals and primary care.
It also needs to be greater responsibility for reform. Independent value -based payment agencies must work with state, territory and federal governments to develop new value -based payments to design, adjust and evaluate.
If you change the supplier behavior using financial incentives, Australia will not be modified. Mental health care crisis Alone. But the government cannot solve the crisis without reforming how to provide and pay incentives for the treatment of improving mental health.
