PMP Briefing Session
Thank you for attending!
Time Item Presenter
1:30 – 1:35pm Welcoming remarks Dr K M CHOY
1:35 – 2:00pm Programme details Dr Leo CHAN
2:00 – 2:15pm IT support Eric HO
2:15 – 3:00pm Q&A session
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“45元睇私家醫生”
“Welcome step to ease care burden”
“六千人受惠”
“以公立醫院協議價格訂購藥物”
“三區推公私營協作”
Background
*
^
#
2011 Population Census, Census & Statistics Department.
Hospital Authority Annual Report 2012-2013, Hospital Authority
Hospital Authority Strategic Plan 2012-2017, Hospital Authority
Hong Kong Population* 3 Districts Population* HA GOPC Attendance in 12/13^
7Mn 1.5Mn 5.6Mn
43 %
Patients have Diabetes Mellitus /
Hypertension#
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Programme Components
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Subsidy Enhanced IT Support
Improved Drug logistics and
management Strong
Cluster Support
Patients & Service Providers
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Target Patients Service Providers
General Outpatient Clinic (GOPC)
Patients
– Hypertension ± Hyperlipidemia
– Incl. Diabetes Mellitus later
– Clinically stable
– Having stayed in HA GOPCs for
12 months by the time they start
service under GOPC PPP
Private Medical Practitioners (PMP)
– Registered Doctors under the
Medical Council of Hong Kong
(MCHK)
– Practising in pilot districts
– Service hours requirement (At least 5 days per week for 3 hours per day)#
# Including sessions by their relieving doctor attending their clinics and providing services in their place
Patient
Programme
Subsidy
(fixed)
PMP
2-way sharing of clinical information
Patient to
pay
prevailing
HA Fee
Doctor
Consultation Drugs Investigations
Service Package
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Patient Journey
Programme Fee
• Principles
– Patients to pay same fee as for HA GOPC
– CSSA and/or waiver patients enjoy the same
fee waiving arrangements as in HA
– HA to pay PMPs the balance or any amount
being waived
– Electronic reimbursement to PMPs 9
Service Package
• Doctor Consultation
– Up to 10 consultations per year
– Covering chronic and acute care
– At least one chronic consultation every 12 weeks*
10 *
Hong Kong Reference Framework for Hypertension Care for Adults in Primary Care Settings, Primary Care Office, HKSAR Government
Programme Fee
• Remarks
– Per mutual agreement, patients may receive further
services and treatment provided by PMPs at their
own expenses outside the Programme
– Those aged ≥70 can pay for non-Programme
services by Health Care Vouchers, as appropriate.
Annual voucher amount will be $2,000 in 2014/15
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Preparation Fee
• To cater for abortive work due to patient’s
defaulted 1st appointment (incl. review of patient’s clinical
information + drugs arrangements + blocked appointment slot)
• One-off for each newly enrolled patient
• To be off-set against the reimbursement for
the patient’s 1st chronic consultation
• $185*/ Patient (= fee for one chronic visit)
12 * With reference to the Fee Survey findings (Consultation Fee for Chronic care)
Programme Fee
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A. Each Clinical Consultation : $235
– Reimbursed monthly
B. Drugs & Additional Clinic Operations :
$89.5/ Quarter
$235 x 10 $89.5 x 4 $2,708/patient/Year
To Summarize Price Level per year
(computation formula)
Elements $ Frequency Total
Amount
Chronic
Consultation
$320^ 4 $1,280
Acute
Consultation
$238* 6
(maximum)
$1,428
Annual TOTAL $2,708
Payment to PMPs per year
(maximum reimbursement)
Elements $ Frequency Total Amount
Chronic Consultation $235
4
6 $2,350
Acute Consultation
Drugs + Additional Clinic
Operation Fee $89.5 4 $358
Annual TOTAL $2,708
^
*
Incl. the averaged amount of annual cost for chronic drugs ($332) and additional clinic operation fee ($208)
Incl. the averaged amount of annual cost for 1 course of Antibiotics ($18) 14
15
470,800
4,708
[per year]
2,000 2,708 4,708
Service Package
• Drugs
– Chronic drugs and up to 3-day episodic drugs ±
1 course of Antibiotics, if necessary
– PMP may use own drugs or purchase specified
Programme Drugs from HA’s Suppliers at GOPC
Programme Price
– Quantity tiering + capping as appropriate
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Anti-HT Lipid-lowering Antibiotics
Lisinopril
Losartan
Perindopril
Atenolol
Metoprolol
Propranolol
Amlodipine
Nifedipine SR
Amiloride / Hydrochlorothiazide
Indapamide
Triamterene / Hydrochlorothiazide
Simvastatin
Amoxycillin / Clavulanic Acid
Ciprofloxacin
Clarithromycin
Supplementary to anti-HT Anti-Diabetic
Aspirin
Prazosin
Potassium Chloride SR
Terazosin
Gliclazide
Metformin
Programme Drugs
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IT Support
• Crucial for continuity of care
• Patients + PMPs will join PPI-ePR / eHR
• Convenient IT platform
– Clinical documentation
– Payment arrangements
• High priority in eHR rollout in 2014/15
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Service Package: Cluster
Support
• Specified investigation
– PMPs can request via IT platform
– Patients can have tests at HA clinics
– Results/ reports auto-sent to requesting PMPs
for necessary follow-ups
• RAMP
• SOPC / other referral 19
Key Support
• Cluster Help Desk
– Designated registered nurses
– Help enroll patients to PMPs
– Provide clinical/ logistic support
– Assist referral to HA for specialist care, if needed
– Revert patients to HA, if necessary
• Hotline for enquiries
• Training sessions on the IT platform
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Stakeholders Engagement
• Extensive consultations
with doctors in the pilot districts
• Key comments
– Generally positive
– Programme can benefit patients/ public at large
– Support in principle
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Community Engagement
• Supported at Tuen Mun and Wong Tai Sin District Councils (DC) on 11 March 2014
• Key comments – Support and welcome the Programme
– Consider the Programme helpful in managing demand on the public sector thru’ leveraging on capacity and capability of the private sector
– Surveyed local residents positive
– Hoped Programme will increase patient numbers / diseases covered
• Invited to Kwun Tong DC on 8 April 22
Initial Programme Implementation
• 3 Pilot districts
– Kwun Tong
– Wong Tai Sin
– Tuen Mun
• Initial planning target = 2,000/ district (i.e. total 6,000 patients)
• Subject to response, will consider expanding
the scope in terms of number of patients /
districts / diseases
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PMP Invitation
• Invitation package sent out on 21 March 2014 – Invitation letter
– Terms and Conditions
– Enrolment form
– PPI-ePR application form
– Request form for pricing info
– Bank auto-payment form
• On-going, individual PMP-based enrolment
• If enroll by 11th April, your name can be included in the 1st doctor list, which will be sent out to patients around mid 2014
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Thank you for your support to
your community
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Patient To find the Programme
attractive and affordable
Can benefit from private
medical services
PMP To find the Programme
acceptable
Able to further contribute
to the public at large
Healthcare System Able to help address the
public-private imbalance with
the sizable number of patients
being diverted from public to
the private sector
IT Platform
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Q&A Session
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Thank you
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