|
Capitaiton Subsidies
|
|---|
| | |
GMS/Nurse
|
Services to Improve Access
|
|---|
|
PHO Type
|
Interim
|
Access
|
All
|
|---|
| | | |
HUHC
|
HUHC
|
Maori/Pacific
|
Non Maori/Pacific
|
|---|
|
Age Group
|
Gender
|
CSC
|
N
|
Y
|
N
|
Y
|
1 thru 4
|
5
|
1 thru 4
|
5
|
|---|
|
00–04
|
F
|
Y
|
$308.12
|
$471.96
|
$315.73
|
$471.96
|
$63.15
|
$126.29
|
$0.00
|
$63.15
|
| | |
N
|
$308.12
|
$471.96
| | | | | | |
| |
M
|
Y
|
$327.88
|
$471.96
|
$332.42
|
$471.96
|
$66.48
|
$132.97
|
$0.00
|
$66.48
|
| | |
N
|
$327.88
|
$471.96
| | | | | | |
|
05–14
|
F
|
Y
|
$79.33
|
$302.61
|
$99.94
|
$302.61
|
$19.99
|
$39.98
|
$0.00
|
$19.99
|
| | |
N
|
$79.33
|
$302.61
| | | | | | |
| |
M
|
Y
|
$75.18
|
$302.61
|
$93.54
|
$302.61
|
$18.71
|
$37.42
|
$0.00
|
$18.71
|
| | |
N
|
$75.18
|
$302.61
| | | | | | |
|
15–24
|
F
|
Y
|
$78.90
|
$291.50
|
$92.22
|
$291.50
|
$18.44
|
$36.89
|
$0.00
|
$18.44
|
| | |
N
|
$36.09
|
$291.50
| | | | | | |
| |
M
|
Y
|
$42.38
|
$291.50
|
$50.75
|
$291.50
|
$10.15
|
$20.30
|
$0.00
|
$10.15
|
| | |
N
|
$20.79
|
$291.50
| | | | | | |
|
25–44
|
F
|
Y
|
$72.61
|
$291.50
|
$81.04
|
$291.50
|
$16.21
|
$32.41
|
$0.00
|
$16.21
|
| | |
N
|
$7.32
|
$291.50
| | | | | | |
| |
M
|
Y
|
$43.16
|
$291.50
|
$52.38
|
$291.50
|
$10.48
|
$20.95
|
$0.00
|
$10.48
|
| | |
N
|
$5.91
|
$291.50
| | | | | | |
|
45–64
|
F
|
Y
|
$88.74
|
$319.27
|
$110.99
|
$319.27
|
$22.20
|
$44.40
|
$0.00
|
$22.20
|
| | |
N
|
$12.22
|
$319.27
| | | | | | |
| |
M
|
Y
|
$67.96
|
$319.27
|
$82.90
|
$319.27
|
$16.58
|
$33.16
|
$0.00
|
$16.58
|
| | |
N
|
$9.57
|
$319.27
| | | | | | |
|
65+
|
F
|
Y
|
$191.27
|
$342.40
|
$191.27
|
$342.40
|
$38.25
|
$76.51
|
$0.00
|
$38.25
|
| | |
N
|
$191.27
|
$342.40
| | | | | | |
| |
M
|
Y
|
$164.95
|
$342.40
|
$164.95
|
$342.40
|
$32.99
|
$65.98
|
$0.00
|
$32.99
|
| | |
N
|
$164.95
|
$342.40
| | | | | | |
- Per capita management fees are paid irrespective of Access or Interim status, and are based upon PHO size:
- • $9.61 per individual up to 20,000 and $4.67 per individual thereafter, for PHOs with fewer than 75,000 registered individuals
- • $6.41 for the first 20,000, $5.83 for individuals 20,001 to 75000, and $5.25 for all others, for PHOs with more than 75,000 registered individuals
-
Definitions
-
PHO Types:
- • Interim PHOs: more than 50% of the registered population of Maori or Pacific Island Ethnicity, or living in areas determined to be in NZ Deprivation Index deciles 9 or 10.
- • Access PHOs: the remainder
-
Individual Characteristics:
- • HUHC: High User Health Card – individual with 12 or more GP consultations in 12 months
- • CSC: Community Services Card – identifies low income or beneficiary status of registered individual – irrelevant for registered patients of Access practices
-
Capitation Subsidy Type:
- • GMS/Nurse: subsidy for first contact services provided by General Practitioner or practice nurse – nominally based upon an effective consultation subsidy of $36.40 for children under 6 and $26 for all other population groups eligible for low or reduced cost access, thereby presuming 13 fully subsidised visits for a HUHC young child and 8.5 for others; 6.3 partially subsidised visits per annum for a 65+ man and 7.4 for a 65+ woman (3.3 and 3.8 fully subsidised visits respectively assuming a $50 cost per visit).
- • Services to Improve Access: capitation to develop access initiatives for high-needs populations (paid in addition to GMS/Nurse capitation
