Budget-holding: The answer to Australian primary care reform?

Abstract

In common with other Organisation for Economic Cooperation and

From the Bottom Up and Other Lessons from Down Under

“…This model is premised on enrolment with a purchaser/provider group, such as the primary care group proposed by Leatt et al, which agrees to share the financial risk for service provision for this enroled membership. Wilton and Smith (1999) have argued that budget holding has been successful in ensuring cost-effective care because of the financial incentives inherent in risk-adjusted capitated payments when the budget holder assumes the financial risk for the healthcare of the enroled population. Chernichovsky (1995) has stated that enrolment ensures the purchaser/providers have both incentive and ability to monitor care practices and outcomes for cost-effectiveness, efficiency and quality of care.…”