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King welcomes reduced costs for older NZers

King welcomes reduced costs for older New Zealanders

More than 305,000 older New Zealanders, who belong to a Primary Health Organisation, will now pay less when they visit their family doctor, says Health Minister Annette King.

Ms King says an extra $47 million in Government funding for Interim-funded PHOs will help lower the cost of visiting a doctor for people aged 65 and older.

"They will also become eligible to only pay up to $3 for many prescribed medicines, as long as the prescription is from their family doctor PHO practice and it is subsidised."

Ms King said she was delighted by the support from all Interim PHOs in reaching agreement with District Health Boards on reduced fees. "About 100,000 New Zealanders aged 65 or older already get reduced or low cost doctor fees through their Access-funded PHO practice, but the extra funding we're now making available means more than 305,000 more older New Zealanders also benefit.''

Ms King also announced today the formation of five new PHOs, in Hutt Valley, Northland (two), Horowhenua and Southland. "This is just the second birthday of PHOs, and the pace with which they have developed has surprised everyone.

"There are now 73 PHOs, providing health care for 3,570,000 New Zealanders. The total number of people, including those aged 65 and over, now benefiting from low or reduced cost visits to PHO family doctors is almost two million."

Ms King said all DHBs had confirmed the Interim-funded PHOs in their region were able to pass on the benefits of the extra funding to their patients aged 65 and older.

"We are seeing very real fee reductions for patients. One of the aims of the Primary Health Care Strategy is to provide better and more affordable access to primary health services for people. The Government is making a significant investment in primary health care -- an extra $759 million over four years from 2002-03 -- to reduce financial barriers and address health disparities.''

Ms King said while cheaper fees were a real benefit for many people, PHOs were also exploring new and innovative approaches to keep their populations well within their community and out of hospital. "A key aspect of the PHO approach is the concept of continuity, the added value that comes from a long-term relationship patients have with their health provider."

Ms King said another important PHO milestone today is the introduction of a new service called Care Plus, for which $26 million has been allocated in 2004-05.

"This programme is aimed at people who need to visit their family doctor or nurse often because of significant chronic illnesses such as diabetes or heart disease. People who have acute medical or mental health needs or a terminal illness are also eligible for the new programme. A total of 18 PHOs will offer Care Plus to their patients from today, with more expected to be added later.

"People who use Care Plus will get an initial comprehensive assessment when they visit their practice and an individual care plan will be developed to set realistic, achievable health and quality of life-related goals, with regular follow-ups,'' Ms King said.

"Care Plus patients will also get effective management of chronic health conditions, better understanding of their conditions and support to make lifestyle changes. All these services will be provided at a low or reduced cost through PHOs.''

Questions and Answers

What does the 1 July initiative mean for older New Zealanders?
From 1 July 2004, more people aged 65 or over who are enrolled with a PHO are eligible to get reduced cost visits to their family general practice and nurse. In addition, they will be eligible to only pay up to $3 for prescribed medicines that are fully subsidised by the Government, as long as the prescription is from their regular family doctor practice.

When do older people become eligible for these benefits through PHOs?
Older people who belong to Access-funded PHOs already get benefits. This covers about 100,000 people aged 65 and older. Some of these people have been getting this benefit since PHOs first began, in July 2002. There are three DHBs that have universal Access coverage for the people in their PHOs. They are Northland, Tairawhiti and Lakes. This means everyone enrolled in a PHO in these areas, including older people, are already getting reduced or low fees when they visit their PHO family doctor. From 1 July, more people aged 65 or older who belong to Interim-funded PHOs also become eligible for low or reduced-cost fees.

How many PHOs are offering older people reduced costs from 1 July?
All 73 PHOs. The 36 Access-funded PHOs established before 1 July 2004 had already been offering older people reduced fees benefits.

Why are there different funding formulae for PHOs?
To make the biggest difference for those who need it most, the Government started by targeting funding at high needs areas first through Access PHOs, to allow practices to reduce patient fees. There are now 36 Access PHOs around the country. When the first two PHOs were set up in July 2002, about 30,000 people were eligible for Access-level funding. There are now more than 1.06 million people receiving low or reduced costs through their Access PHOs, but the Government is also making sure other groups can benefit through Interim-funded PHO practices as quickly as possible as well. This started with extra funding for young people aged 6-17 in October 2003, low-cost prescription fees for many medicines for high needs groups from 1 April 2004, as well as the extra funding for older people aged 65 years and over from 1 July 2004.

How many PHOs are there?
From 1 July 2004 a total of 73 PHOs will be operating. Thirty-six are Access funded, 21 are Interim funded and 16 are mixed (interim PHOs with some practices in the area that qualify for Access funding).

Are there any new PHOs operating from 1 July?
Yes, there are five::Tamaiti Whangai (Hutt Valley DHB, Interim), Hokianga (Northland DHB, Access), Whangaroa (Northland DHB, Access), Horowhenua (MidCentral DHB, mixed), Eastern and Northern (Southland DHB, Interim).

How do I know if I belong to a PHO?
Ask your regular family doctor or nurse if they are part of a PHO and whether you are enrolled in it. Or you can ring 0800 HLTH4U (0800 252 464) to check.


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