Practice Incentive Program

The intention of the Practice Incentive Program is to recognise general practices that provide comprehensive, quality care, and which are either accredited or working towards accreditation against the Royal Australian College of General Practitioners' (RACGP) Standards for General Practices.

The PIP is part of a blended payment approach for general practice. Payments made through the program are in addition to fee for service income. Payments are calculated according to various formulae that take into account factors such as practice size and patient demographics. All PIP payments (excluding teaching and procedural GP) are paid according to the SWPE for the practice. The SWPE is the standardised whole patient equivalent and is essentially the proportion of care provided by the practice to patients attending the practice during the reference period.

Medicare Australia will automatically calculate a practice's entitlement for payments based on information provided in the application form and subsequent amendments. In some cases (such as teaching of medical students) practices need to supply additional information as it becomes available. PIP payments occur in February, May, August and November of each year.

Practice incentive payments are made to the whole practice, in contrast to service incentive payments, which are made to the individual provider of the service.

Service Incentive Payments are paid in addition to the normal Medicare benefit for the particular items and are paid quarterly in February, May, August and November. Payment is dependent on the date of processing by Medicare/Veterans Affairs.

Quicklinks:

• Practice Incentives Program (PIP) - New eHealth Incentive
• Practice Incentives Program (PIP) - Aged Care Access
• Practice Incentives Program (PIP) - Information Management/Information Technology (IM/IT) Incentive
• Practice Incentives Program (PIP) - After hours Incentive
• Practice Incentives Program (PIP) - Practice Nurse Incentive (PNI)
• Guidelines for Practice Nurses and/or Allied Health Workers for urban areas of workforce shortage [PDF, 118Kb]
• Practice Incentives Program (PIP) - Quality Prescribing Incentive (QPI)
• Practice Incentives Program (PIP) - Teaching Incentive
• Practice Incentives Program (PIP) - Rurality Loading
• Practice Incentives Program (PIP) - Cervical Screening Incentive
• Practice Incentives Program (PIP) - Asthma Incentive
• Asthma Cycle of Care: Completing the Asthma Cycle of Care â€" A guide for General Practitioners [PDF, 204Kb]
• Practice Incentives Program (PIP) - Diabetes Incentive
• Practice Incentives Program (PIP) - Procedural GP Payment
• Practice Incentives Program (PIP) - Domestic Violence Incentive

New Indigenous Health Incentive

The new Indigenous Health PIP will commence in May 2010 and is part of the Commonwealth Governments ‘Closing the Gap’ funding.  Practice participating in PIP will need to meet specific sign on requirements and Medicare will be writing to PIP Practices and providing them with the necessary documents in early 2010.

Practice Incentives Program (PIP) - Indigenous Health Incentive

New eHealth Incentive

The PIP eHealth Incentive was announced as part of the 2008-09 Budget, and will start from August 2009. The incentive aims to encourage use of electronic health systems in PIP practices. The PIP eHealth Incentive will replace the existing PIP IM/IT Incentive, which will cease in August 2009. This new incentive aims to encourage general practices to keep up to date with the latest developments in eHealth. The eHealth Incentive will be incorporated into the PIP payments with a payment level of $6.50 per Standardised Whole Patient Equivalent (SWPE). Payments will be capped at $12 500 per practice per quarter, up to a maximum of $50 000 per year.

• eHealth Application form [PDF, 123Kb]
• eHealth Application form [RTF, 533Kb]
• eHealth Guidelines [PDF, 205Kb]
• eHealth Guidelines [RTF, 139Kb]

Aged Care Access

Effective July 2008, a new SIP incentive was introduced - the Aged Care Access Initiative. This is an incentive payment designed to encourage GPs to provide more services in Residential Aged Care Facilities. GPs participating in the PIP will be eligible for incentive payments if they meet Qualifying Service Levels (QSLs) for the provision of care in RACFs in a financial year.

There are two payment levels under the Aged Care Initiative and annual payments are capped at $2 500 per provider per financial year. The first payment is expected in February 2009 with payments quarterly thereafter (as per existing SIPs) for GPs reaching the QSLs.

Payment:     Tier 1 - $1 000 on reaching QSL of 60 MBS items claimed in the financial year
Tier 2 - $1 500 on reaching QSL of 140 MBS items claimed in the financial year (an additional 80 items after reaching Tier 1)

Web links:

Medicare Australia

http://www.medicareaustralia.gov.au/provider/incentives/pip/index.jsp

http://www.medicareaustralia.gov.au/provider/incentives/index.jsp

Medicare Australia PIP Newsletters