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Considered Health

Issue 19 - Health Newsletter

 

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"Everything in life has some risk, and what you have to actually learn to do is how to navigate it."
- Reld Hoffman
Co-founder | LinkedIn

Quality Improvement Practice Incentive Payment

The Department of Health has just released their guidelines for the new Quality Improvement Practice Incentive Payment (QI PIP) commencing on 1 August 2019, sending a strong message about the value of health data and the importance of using this data to improve the quality of care delivered through general practices across Australia. 

https://www.health.gov.au/internet/main/publishing.nsf/Content/PIP-QI_Incentive_guidance  

Eligible practices can receive a maximum payment of $12,500 per quarter ($50,000 annually),  based on $5.00 per Standardised Whole Patient Equivalent, per year. Rural loadings are expected to apply for rural and remote practices.   

The QI PIP replaces four other incentive payments which will cease:

  • Quality Prescribing 
  • Diabetes 
  • Asthma 
  • Cervical Screening 

A general practice will need to meet two components to qualify for a PIP QI Incentive payment. 

  1. Participation in continuous quality improvement activities (in Partnership with the local PHN), 
  2. Submission of a PIP eligible data set (quarterly) based on the following 10 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 

From 1 August 2019, general practices, ACCHS (Aboriginal Community Controlled Health Services) and other IAHP (Indigenous Australian's Health Program) organisations may apply for the QI PIP Incentive online through Health Professional Online Services (HPOS) using their Provider Digital Access (PRODA) account.

           

Changes to Health Workforce Classifications & Boundaries

From 1 July 2019 the health workforce classification system and boundaries have changed.  These changes are expected to have a significant impact on the GP workforce. 

Summary of changes:

  • The District of Workforce Classification (DWS) no longer applies to GPs, it only applies to specialists. For GPs - DWS has been replaced by Distribution Priority Area (DPA).
  • International Medical Graduates (IMGs - GPs immigrating from overseas) will need to work in DPAs to be eligible for Medicare.
  • Blanket rules applying to DPA include:
    • Inner-metropolitan areas are automatically deemed non-DPA, 
    • areas of remoteness classified between 5–7 under the Modified Monash Model are automatically deemed DPA,
    • the entire Northern Territory is automatically deemed DPA.
  • These boundaries are set for the next 3 years.
  • Click the link to view the map: https://beta.health.gov.au/resources/apps-and-tools/health-workforce-locator 

Strategic Issues:

  1. Practices that were previously located in DWS areas and relied on this classification to recruit doctors from overseas are likely to struggle to replace doctors when they leave. 
  2. Rural regions with larger populations are classified as not being DPA, making it very difficult for them to recruit GPs. 
  3. DPA areas close to metropolitan suburbs are likely to be the targeted for new practices to host IMGs. 
  4. Small regional towns that are automatically DPA due to the Modified Monash Model, could also be targeted even though there are sufficient GPs in the town to service the population. 
  5. It is expected that there is likely to be less IMGs immigrating to work in Australia. A majority of the additional doctors that are being trained in Australia are not choosing to become GPs, and those that are do not want to work outside of the inner suburbs. These changes, that have been designed to address the GP workforce crisis in communities with the highest needs, may do the opposite and escalate the GP Workforce crisis.

This article provides further insights: https://www1.racgp.org.au/newsgp/professional/changes-to-health-workforce-distribution-system-co

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Single Touch Payroll | What is it?

The Government and Australian Tax Office (ATO) introduced a new process to streamline the way employers report payroll information. Single Touch Payroll (STP) currently provides a reporting framework to deliver payroll and superannuation information to the ATO earlier than which currently applies under the PAYG withholding ordinary provisions. This means an employer paying weekly wages will report gross wages, tax withheld and superannuation contributions to the ATO every week when the employees are paid. 

Who does it applies to?

As of 1 July 2019, all small employers (19 or less employees) will need to report. Larger employers have already been reporting since 1 July 2018. Many employers' current payroll software solution should be suitable for the new STP reporting requirements, with only a minor update required to enable the feature.  For employers with 1-4 employees, alternate options will be made available by the ATO to help with the transition to STP reporting obligations. Other options available include initially allowing your registered tax or BAS agent to report quarterly, rather than each time payroll is run, or a full exemption to STP reporting if you have no internet or an unreliable connection.

What do you need to do?

If your business currently does not use payroll software, the ATO will not force you to purchase such software. Low-cost STP 

solutions such as simple payroll software, mobile phone apps and portals have been developed to help smaller employers deal with changes. A list of some of the solutions currently available can be found on the ATO website:  https://www.ato.gov.au/business/single-touch-payroll/in-detail/low-cost-single-touch-payroll-solutions/. The ATO has a requirement that such solutions cost $10 or less per month. 

How can Brentnalls Health help?

If you would like to discuss STP or require any assistance setting up your software, please contact our office and ask to speak to one of our health team members.

 

 

The Future of the Medical Workforce

ANZ have released an industry report written by Professor Anthony Scott (Melbourne Institute: Applied Economic & Social Research, The University of Melbourne). It provides some very interesting insights into the factors that are influencing the evolution of the future medical workforce.  Below we have summarised a selection of quotes from the report.

  1. Growth of the medical workforce and increased competition
  • The total number of doctors has increased by 5.3 per cent per year, from 59,359 in 2005 to just under 94,000 in 2017; 2.7 per cent per year over and above population growth.
  • Although absolute doctor numbers have increased, average hours worked have fallen.
  • Health Workforce Australia predicted a potential shortage of 1,000 advanced vocational training positions by 2030 (Health Workforce Australia, 2014).
  • Increasing job insecurity and competitive pressures are widely thought to be adding to existing levels of stress, burnout and mental health issues amongst junior doctors (Beyond Blue, 2013).
  1. Earning on the rise
  • Doctors' earnings are increasing over time…above the rate of inflation across most groups.
  • More competition amongst GPs leads to lower fees and higher bulk-billing (Gravelle et al, 2016) but there is no evidence on this issue for non-GP specialists, where the growth in supply is higher than for GPs.
  • The majority of specialties experienced a real increase in hourly earnings, with the largest increases for Rheumatology, followed by Infectious Diseases, Ophthalmology, and Dermatology. Hourly earnings fell in real terms for General and Orthopaedic Surgery, Endocrinology, Cardiology and Intensive Care.
  1. Impact of the private medical sector
  • Though the public–private mix of doctors has not changed much over time (Scott, 2018), in the future budget-constrained public hospitals may be less able to absorb growth of the qualified medical workforce over and above inflationary increases in hospital funding.
  • Consolidation is driven by economies of scale and a search for better work-life balance.
  • In 2017, only 4.6 percent of GPs reported being in a solo practice, down from 11.6 percent in 2008, whereas the proportion of GPs in practices with ten or more GPs has increased from 15.5 percent in 2008 to 27.3 percent in 2017.
  1. Facing the digital age
  • The evolution of the medical workforce will be influenced by continued improvements in technology, information and data.
  • The uptake of digital technology by doctors is likely to increase since the junior doctors of today have grown up using and interacting with it.
  • New innovative tests and treatments require different sets of skills, roles and tasks, and thus a different combination of health professionals to deliver the same level of medical care.
  • Digital decision support systems, such as electronic dashboards and clinical guidelines built into medical software, are an important vehicle for ensuring the uptake of new clinical evidence; providing support and guidance in medical decision-making; and reducing medical practice variations and low-value care.

Against a background of changing patterns of disease and multiple morbidities, increasing concern about low-value care and waste, and increasing patient expectations and technological change, the medical workforce will need to adapt now in order to provide improved, value-based and more accessible healthcare in the future.

Click here for a copy of the full report.  It's worth a read.

 

10 New Financial Year Resolutions

We have recently celebrated the end of the 2019 Financial Year.  And just like New Years' Day, when you make all sorts of New Years' Resolutions about getting fit, eating better or spending more time with loved ones, 1 July is a great time to set some New Financial Year's Resolutions.

Here are our top 10 resolutions for you to consider for FY2020:

  1. Set your Financial Goals
  • Think about what your needs/wants and goals will be in the short, medium and long term. Then consider whether your financial situation will allow you to meet these. You may need to seek some advice on how to plan financially for the years ahead, so you can meet your financial goals.
  1. Keep thorough records for Financial Statements and Tax
  • To minimise your tax bill, make sure you keep full records of income and deductible expenditure throughout the year. Also ensure important financial documents are retained and filed in an easy to manage and access way. Our website has some handy checklists which can assist: https://www.brentnalls-sa.com.au/resources/checklists
  1. Manage your Obligations as an Associate / Contractor
  • If you are working as an Associate or Contractor, ensure you are appropriately registered for your ABN and GST, and on top of preparing your Business Activity Statements, including claiming all the GST credits you are entitled to from the records you have kept in resolution 2.
  1. Stay on top of your employer obligations
  • If you are a practice owner and employ staff, ensure you are on top of the latest changes regarding Single Touch Reporting for Payroll. Also, there are some important changes coming which may impact the deductibility of payments to staff if not reported correctly. Keep an eye out for our next Brentnalls SA newsletter for more information.
  1. Understand your structure
  • You may have a company, family trust, SMSF or other entity within your Group. You may not have either of these, but a new entity may be useful. A review of your group structure and some actions to either wind up old entities, or establish new entities can help make your structure more efficient, tax effective and protect your assets in certain circumstances.
  1. Investment Options for Wealth
  • You have worked hard and been able to build some savings. In the current low interest rate environment, money sitting in a bank account may not generate a suitable return. Consider your investment options, and engage an expert if appropriate to ensure your savings are put to work.
  1. Review your Bank Debts & Finances
  • Similarly, after two recent interest rate cuts, speak to your banker to ensure that you are getting the benefit of these.
  1. Super Charge your superannuation
  • Through to 30 June, we have been speaking with clients about the tax savings available through concessional contributions to Super. The best time to start thinking about these is right now, so you can plan and make contributions throughout the year.
  1. Protect Yourself and your Assets
  • Your most valuable and important asset is yourself and your family. Ensure you have appropriate insurances in place to support and protect you should an unfortunate life event occur. Also, if you have not had your Wills and Estate Plan reviewed recently, make a resolution to get these updated.
  1. Assemble your Team of Advisers
  • You are not alone. Help is available for the above 9 resolutions, whether that be through your accountant, financial planner, lawyer, banker or insurance broker. Make sure you have an open, trusting relationship with your professional advisers.

At Brentnalls Health, we are capable and happy to help you with many of these resolutions. Where we may need some outside expertise, we have great relationships with a number of advisors who we are happy to recommend.

 

WORKSHOP



AMPHEaT & Brentnalls Health

INVITE

Practitioners & Practice Managers to our next workshop on:
Financial Literacy for Doctors

Tuesday, 3rd September 2019
Level 1, 313 Payneham Road, Royston Park
6pm Registration / Light Dinner
6.30pm - 8.30pm Workshop


This information session will cover the following topics:
- Understanding tax/financial obligations
- Understanding ATO expectations
- Tax minimisation strategies
- What can/can't be claimed
- Paid employee vs ABN
- BAS statements
- GST – registered / not registered
- Structures to grow and protect your wealth
- The power of the time value of money
- Smart investment strategies
- Superannuation / Salary Sacrifice
- Family Trusts

FREE - Includes a light dinner, beer, wine and soft

REGISTER HERE
 


Business For Doctors Conference 2019

The Brentnalls Health team flew up to Brisbane for the "2019 Business for Doctors Conference".

We know topics below are top of mind for doctors in business, and it was a great opportunity to share our insights from our experience:

  • Strategic Planning (Danny Haydon | Principal)
  • Valuing a Medical Practice (Matthew Holden | Partner)
  • Strategies to Minimise Tax & Common Tax Deductions (Stefan Sapio | Manager)
  • Business Analytics for Medical Practices (Rick Albertini | Managing Partner)
  • PSI Rules, Structuring & Service Entities for Doctors (Christina Gulliver | Principal)
  • 2019 Hot Topics & Budget Update (Shali Manolev (Partner) and Danny Haydon (Principal))

We enjoyed the opportunity to talk with delegates, providing them with resources such as information documents, and the M&M's we handed out were a great hit!

The conference was well received and we're looking forward to next year's conference in Melbourne. We hope to see you there.

   

Adelaide Children's Dentistry

Congratulations to our client Dr Wendy Cheung on the opening of her new paediatric dental practice 'Adelaide Children's Dentistry' at 165 Unley Road, Unley. The new practice opened its doors and saw its first patient on 18th June 2019. We wish Wendy and her team all the best with their new practice.

     

 


The information provided in this newsletter does not constitute advice. The information is of a general nature only and does not take into account your individual objectives, financial situation or needs. It should not be used, relied upon, or treated as a substitute for specific professional advice. We recommend that you contact Brentnalls SA before making any decision to discuss your particular requirements or circumstances. Brentnalls is not a partnership or a joint venture. Instead, the business of Brentnalls SA is independently owned and operated and it is an independent member of the Brentnalls Affiliation of Accounting Firms. Individual member firms do not accept responsibility or liability for the actions or inactions of any other individual member firm.
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