PIP Quality Improvement (PIP) supports general practice activities that encourage continuing improvements; quality care; enhancing capacity; and improving access and health outcomes for patients. A redesigned program began on 1 August 2019.

The PIP was simplified by combining four existing incentives into one Quality Improvement (QI) incentive.

The four incentives that ceased on 31 July 2019 were: Asthma Incentive; Quality Prescribing Incentive; Cervical Screening Incentive; Diabetes Incentive. The Australian Government decided to retain the General Practitioner Aged Care Access Incentive.

The following incentives continued: eHealth Incentive; After Hours Incentive; Rural Loading Incentive; Teaching Payment; Indigenous Health Incentive; Procedural General Practitioner Payment and General Practitioner Aged Care Access Incentive.

Incentive components

A general practice has to meet two components to qualify for a PIP QI incentive payment:

1. Participation in continuous quality improvement activities
2. PIP Eligible Data Set

What Are the PIP Quality Improvement Components?

The PIP Quality Improvement (QI) Incentive is designed to support continuous quality improvement in general practice through practice data and structured improvement activities. The core components include participation in quality improvement activities and the provision of the required PIP Eligible Data Set. Practices can use their data to identify priorities, monitor performance and work with their local Primary Health Network (PHN) on improvement activities. This data-driven approach can help practices connect quality improvement with patient needs, service planning and better healthcare outcomes.

The QI PIP gives practices more flexibility to focus on the needs of their practice population, including vulnerable and high-risk groups, in partnership with their Primary Health Networks (PHNs). Practices are encouraged to use their practice data; the local PHN health needs assessment; and benchmark reports from some PHNs to identify needs-based population health quality improvement opportunities, called Improvement Measures. For example, a practice may consider whether their patients marked in clinical software with a diagnosis of depression or anxiety disorders have been regularly recalled or followed up for reviews of their mental health treatment plans, and reissue referrals to mental health professionals if warranted. Or it may be that a clinician has a specific interest in improving respiratory health of patients and looks at the number of patients with a chronic respiratory illness and how the practice’s service delivery model could be improved. For example, practice data may provide evidence that supports a business case for a chronic disease management nurse clinic.

How Can PIP Support General Practice Quality Improvement?

PIP support can help practices turn clinical data into practical quality improvement priorities. This may involve reviewing practice performance, identifying gaps in care, strengthening data quality and developing improvement activities that reflect the needs of the practice population. Local PHNs can provide different levels of support, while external consultants such as Larter can assist practices with data analysis, quality improvement planning and identifying opportunities to strengthen practice performance. The aim is to make quality improvement a useful part of routine general practice rather than simply a reporting exercise.

Using PIP Quality Improvement Data for Mental Health and Chronic Care

PIP quality improvement activities can be used to examine areas of care that are important to a practice population, including mental health and chronic disease management. Practices may review clinical data to identify gaps in follow-up, screening, recalls or care planning and then develop targeted improvement activities. For example, a practice could examine how consistently patients with mental health conditions are reviewed or whether patients with chronic respiratory conditions are receiving appropriate preventive care. This approach allows quality improvement priorities to be informed by local patient needs and practice data.

Practices will no longer be directed to focus on predetermined specific diseases.

The Department of Health worked with the Practice Incentives Program Advisory Group (with representatives from the RACGP, the Australian Medical Association, the Australian College of Rural and Remote Medicine, the Rural Doctors Association of Australia, the Australian Association of Practice Managers and the National Aboriginal and Community Controlled Health Organisations) to ensure the redesigned PIP would be agile for different contexts, avoiding the potential negative aspects of rigid ‘pay for performance’ initiatives, where providers who care for the poorest and sickest people tend to be penalised (e.g. it may be easier to achieve specific diabetes targets for people in Toorak or Bulimba, than in Dandenong or Cunnamulla).

Quality improvement measures data

Practices need to meet eligibility criteria to receive the QI incentive, including accreditation against the RACGP Standards for General Practices. The new incentive also requires practices to share aggregated and de-identified data extracted from their clinical software with their local PHN, based on the following ten quality Improvement Measures:

1. Proportion of patients with diabetes with a current HbA1c result
2. Proportion of patients with a smoking status
3. Proportion of patients with a weight classification
4. Proportion of patients aged 65 and over who were immunised against influenza
5. Proportion of patients with diabetes who were immunised against influenza
6. Proportion of patients with COPD who were immunised against influenza
7. Proportion of patients with an alcohol consumption status
8. Proportion of patients with the necessary risk factors assessed to enable CVD assessment
9. Proportion of female patients with an up-to-date cervical screening
10. Proportion of patients with diabetes with a blood pressure result

This information will be collated at the local level by the PHNs to assist in supporting improvement and understanding health needs. However, practices, of course, need good quality data to get the most out of this PIP for their patients. Larter can help individual practices to analyse their data to support both financial sustainability and quality improvement (though we do not seek to replicate the work of PHNs).

For example, with Medicare rebates not keeping up with inflation for some years, it’s never been more important for practices to know what they are entitled to claim. Larter can support general practice with an audit of practice revenue sources, including claims for the PIP, and recommend how a practice may increase its revenue. Practices will be eligible for up to $12,500 per quarter through this incentive program.

Conclusion

PIP Quality Improvement gives general practices a structured way to use practice data, identify areas for improvement and respond to the needs of their patient population. Effective quality improvement goes beyond meeting program requirements; it can help practices strengthen clinical processes, improve data quality and support better patient care. For practices that need additional capability, Larter can provide practical support with data analysis, quality improvement planning and practice performance improvement, working alongside existing PHN and primary care support.

Frequently Asked Questions