Five key recommendations on how Australia should approach, price, and fund virtual care are made.
Last week the Independent Health and Aged Care Pricing Authority released their final report into the current state of virtual care both at home and abroad.
The project, which was initiated in January 2024, came after IHACPA engaged the Nous Group and Health Policy Analysis to “undertake a review of virtual care to better understand virtual care activity, costs, and models of care in Australia and internationally”.
The report makes five key recommendations, which will hopefully inform how the country should approach, price, and fund virtual care models. The recommendations are:
- Develop a nationally consistent definition and taxonomy of virtual care;
- Improve the visibility of virtual care in national data collections;
- Improve national consistency in the identification and allocation of virtual care costs;
- Consider including virtual care as a supplementary collection to the National Hospital Costs Data Collection in order to cost service innovations;
- Establish a means of transitioning service innovations to activity-based funding or other alternative funding models that improve value.
Each recommendation has been assigned a timeframe, either short- (one to two years), medium- (three to five years), or long-term (six to 10 years).
For the purposes of the report, virtual care included telehealth (both telephone and/or video), remote patient monitoring, asynchronous communications, and website and remote applications. These modalities are used in a variety of settings, including chronic care management, care navigation, virtual ward rounds, in-reach into residential aged care, and hospital in the home.
Insights into current funding mechanisms and models of virtual care were obtained through a literature review and desktop scan of 45 peer-reviewed publications and 170 grey literature documents, as well as a two-stage consultation process involving over 150 stakeholders.
The list of consulted stakeholders included health departments and local hospital networks from jurisdictions across the country, as well as a range of peak bodies and clinical and hospital groups such as Ahpra, the Australian Institute of Digital Health, and the Australian Medical Association.
Five international health services – Canada, Denmark, Germany, the UK, and the United States – were also reviewed and interviewed to learn more about how they approach virtual care.
There has been a clear increase in demand for virtual service delivery since the covid pandemic, with hospitals and health services doing their best to improve their offerings.
“Virtual care service delivery has accelerated nationally, with 12% growth in use of virtual service models for non-admitted services along in the past five years (an increase from 11.9% in 2018-19 to 23.5% in 2023-24,” the report read.
“While traditional mechanisms of virtual in-reach services have existed within rural and remote services for decades, virtual care is increasingly becoming a priority due to its potential to expand access to existing hospital services or to provide new models to facilitate hospital avoidance when patients can be managed in alternative environments.”
The report also detailed other funding-related issues.
Related
“Medicare benefits are generally not payable for professional services where other government funding is already provided for that service. Jurisdictions are concerned this issue limits the ability of public hospitals to involve GPs and other specialist clinicians in private practice to participate with colleagues working in public hospitals in virtual care activities,” it reads.
“While it is appreciated this is an enduring funding issue that equally applies to in-person care, the issue appears amplified in the virtual care setting, which facilitates clinicians from a variety of settings to more readily work collaboratively.”
IHACPA will now consider the contents of the report before developing how to implement the key findings and recommendations. Further engagement with relevant stakeholders will occur as needed.
The final report from the IHACPA Virtual Care Project is available online.