High User Health Card (HUHC) versus CarePlus The objective of this communication is to help practices evaluate the best programme choice for each patient and for the practice, taking both financial and patients care into consideration. As the HUHC and CarePlus are funded from the same funding pool, a patient can only be registered on one or the other.
Criteria for Each Programme in Outlined in Brief: High User Health Card The High Use Health Card (HUHC) gives a general practice a higher government subsidy for patients with high health needs. This means that the practice can spend more time on developing plans to better manage the patient’s health condition/s. To be eligible the patient needs to have visited a health practitioner at the general practice they are enrolled in, 12 or more times in 1 year, with the consultations being related to a particular condition or condition(s) stated which are ongoing. The general practice needs to have a record of the 12 visits, and the doctor will need to make the application on the patient’s behalf for a HUHC. The card lasts for 1 year, after which time a new application can be made (if appropriate). *** During COVID-19 consults can be phone or virtual as well as face to face https://www.health.govt.nz/system/files/documents/pages/application-huhc-form-jun14-v2.pdf
CarePlus Care Plus funding is provided to general practices to improve chronic care management, reduce inequalities, improve primary health care teamwork, and reduce the cost of services for high health need patients. CarePlus is aimed at people with chronic health conditions, serious medical or mental health needs, or terminal illness, you can find the qualification criteria in greater detail in the WBOP PHO Patient Services Guide on the PHO Portal. CarePlus provides funded consultants for the patient to receive more intensive care. It is not just about access to lower-cost care; it is a way of improving patient health outcomes all-round. *** During COVID-19 consults can be phone or virtual as well as face to face Claim using the Halcyon form. Medtech, MyPractice and Profile PMS An invoice will automatically be created in your PMS and a claim will be electronically sent to the PHO on completion of the Halcyon form. Houston PMS An invoice will need to be manually created in your PMS for internal reconciliation purposes. A claim will be electronically sent to the PHO on completion of the Halcyon form. 1
High User Health Card (HUHC) versus CarePlus Table that illustrates the financial differences between the two programs
Key Annual capitation for enrolled person per annum Extra capitation for HUHC per enrolled person per annum Annual Payment for CarePlus per person per annum Shows which funding stream is greater per annum – HUHC or CarePlus
Comparative Programme Summary: HUHC • • • • •
CarePlus •
HUHC is a subsidy added to monthly capitation HUHC holder may receive lower cost consults Greater financial benefit to practice Time consuming application process Expires in 12 months.
• • • • •
Fee for service, enrolment consult and 3 reviews over 12 months All 4 consultations MUST be done to get full payment Must receive lower cost consults Greater cost benefit to patient Eligibility and enrolment simple Expires in 12 months
The Opportunity: Review your CarePlus allocation available and who might qualify for CarePlus or HUHC. Discuss with your teams how you could use this funding to support your patients in these challenging times of COVID-19, where there is financial pressure for both practice and patient. During COVID-10 virtual consultations can be used for both programmes and this offers an opportunity to reach out to patients. Where you identify that a practice qualifies for CarePlus, your can proactively contact them for enrolment via the telephone, then create a Care Plan to support and keep in touch with them; especially during this time of self-isolation. Please contact your General Practice Liaison if you have any questions or would like to disuss. Catherine, Debbie, Donna, Emma and Liz 2