In preparing for National Health Insurance (NHI) ICPA is a participant in the NHI Work Stream 3 which deals with the Purchaser Provider split and the contracting of service providers, delivery models of healthcare and the re-imbursement thereof. In the consultative process, ICPA has provided contracting models for consideration, a summary of which is contained below:
The ICPA offers NHI, a mechanism to improve access to services at Primary Healthcare level, while also improving opportunities and incentives not only to existing pharmacies but as a mechanism to expand into rural communities. Since Primary Health Care is an integral part of NHI Health Care Service Benefits, ICPA has proposed that it consider the Essential, Advanced and Local Advanced Services.
That the services be costed in accordance with the South African Pharmacy Council Board Notice 33 of 2012 which determines the services for which a Pharmacist may Levy a Fee and the re-imbursement thereof.
The principle of a hybrid Capitated Fee For Service (FFS) model be considered i.e. a FFS model for a dispensing function, but as the community pharmacy becomes more involved in the health of the patient, that a capitated model be considered. (The DoH is pro capitation arrangements and is trying to move away from FFS arrangements).
A performance based on health outcomes as well as risk stratification of the population will be considered.
A community pharmacy model, multidisciplinary group practices, areas of need, the burden of disease and the DoH’s CCMDD program and PuP’s were also discussed.
Community Pharmacies involvement in NHI could be cost saving and have an improvement on healthcare outcomes.download movie xXx: Return of Xander Cage 2017
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