Primary Health Organisation

Primary Health Organisations (PHOs), in New Zealand, are a collection of health providers, which are funded on a capitation basis by the New Zealand Government via its District Health Board. They are usually set up as not-for-profit trusts, and have as their goal the improvement of their population's health.

History of PHOs

In the early 1990s, general practices were joining together to form groups known as "Independent Practitioner Associations" or "IPAs". They did this to better negotiate with the purchasers of healthcare at that time.

Prior to the introduction of PHOs, general practitioners have been paid using a "fee for service" model. For every person that went through their door, the GP received a set amount of money from the state. For some time previous, the Government had been trying to introduce a "capitation" model for some time before this, that is give practices a set amount of money depending on the population that they serve.

These voluntary IPAs forming, gave the Government an important stepping stone to introduce capitation-based funding. In 2001, the Government introduced PHOs, which were similar to the already existing IPAs.

In July 2002 the first PHOs were formed [Ministry of Health. [http://www.moh.govt.nz/pho Primary Health Care] . Retrieved 14 June 2007.]

tructure and goals of a PHO

A PHO is set up as a not-for-profit with both community and provider representation. They maintain a list of their enrolled populations for which they get funding.

PHOs include not just GPs and nurses, but also other health providers.

Funding of PHOs

Primary Health Organisations are allocated funds depending the characteristics of their enrolled population (this is called capitation).

The PHO receives a set amount of money from the District Health Board for every member, depending on their age, sex, ethnicity and socioeconomic status. They are also allocated funds for health promotion, individuals with special care requirements, as well as for rural practice.

Health care providers that are part of PHOs also have the right to charge fees to their patients for each visit.

PHOs may also receive funding through contracting with the Ministry of Health, District Health Boards or other organisations such as Accident Compensation Corporation (ACC). Usually these contracts are to provide specific services or to pass on additional subsidies to target patient groups (over and above ordinary capitaion subsidies).

This new policy costs the Government more money to implement, and the expected proportion of each GP visit paid by the Government is higher than it has been previously. This means that by-and-large, New Zealanders can expect to pay less for a visit to the doctor.

Perceived advantages of PHOs

Benefits for individual patients

* Overall lower fees
* Wider range of services

Benefits for the population as a whole

* Encouragement of rural practice
* Increased emphasis on preventative measures
* Services tailored to the needs of the communities PHOs serve

Benefits for general practices

* Steady and predictable stream of income
* Better use of nurses (previously, a doctor had to see a patient for a practice to get paid by the Government)

References

External links

North Island PHOs
* [http://www.wipa.org.nz/PHO_Capital/CapitalHome.aspx] Capital PHO.
* [http://www.wipa.org.nz/PHO_Kapiti/KapitiHome.aspx] Kapiti PHO.
* [http://www.laketaupopho.co.nz] Lake Taupo PHO.
* [http://www.wipa.org.nz/PHO_Otaki/OtakiHome.aspx] Otaki PHO.
* [http://www.ptpho.org.nz] Pinnacle Taranaki PHO.
* [http://www.tamakihealthcare.org.nz] Tamaki Healthcare.
* [http://www.wipa.org.nz/PHO_TuMai/TuMaiHome.aspx] Tumai Mo Te Iwi.
* [http://www.tpho.org.nz] Turanganui PHO.
* [http://www.waikatopho.org.nz] Waikato PHO.
* [http://www.wipa.org.nz/PHO_Wairarapa/WairarapaHome.aspx] Wairarapa PHO.
* [http://www.wrpho.org.nz] Whanganui Regional PHO.

Management Services to PHOs
* [http://www.pinnacle.org.nz] Pinnacle Group
* [http://www.wipa.org.nz] WIPA
* [http://www.compasshealth.org.nz] Compass Health

More information about PHOs:

* [http://www.moh.govt.nz/moh.nsf/wpg_Index/About-Primary+Health+Care+Strategy+Implementation Primary Health Organisations (PHOs) – Q&As] Questions and answers about PHOs, targeted at general population.
* [http://www.moh.govt.nz/moh.nsf/wpg_index/-Primary+Health+Care+Established+PHOs+by+DHB Ministry of Health - Established PHOs by DHB] A list of all PHOs in New Zealand.