The Practice Incentives Program (PIP) is a key driver of quality care in the general practice sector.
In the 2016/17 Federal Budget, the Australian Government announced it would work towards changing the PIP through the measure entitled, "Quality Improvement in General Practice - Simplification of the PIP".
The redesign of the PIP will introduce a new Quality Improvement Incentive which will give general practices increased flexibility to improve their detection and management of a range of chronic conditions, and to focus on issues specific to their practice population.
For further information read this handout.
The intention of the Practice Incentive Program (PIP) is to recognise general practices that provide comprehensive, quality care. To qualify for the PIP practices must be accredited, or working towards accreditation, against the Royal Australian College of General Practitioners' (RACGP) Standards for General Practices.
The PIP is part of a blended payment approach for general practice. Payments made through the program are in addition to fee for service income. Payments are calculated according to various formulae that take into account factors, such as practice size and patient demographics.
All PIP payments (excluding teaching and procedural GP) are paid according to the Standardised Whole Patient Equivalent (SWPE) for the practice. The SWPE is essentially the proportion of care provided by the practice to patients attending the practice during the reference period.
Medicare Australia will automatically calculate a practice's entitlement for payments based on information provided in the application form and subsequent amendments. In some cases (such as teaching of medical students) practices need to supply additional information as it becomes available. PIP payments occur in February, May, August and November of each year.
Practice incentive payments are made to the whole practice, in contrast to Service Incentive Payments (SIP), which are made to the individual provider of the service. SIP payments are associated with the completion of the diabetes annual cycle of care, completion of the asthma cycle of care, and with cervical screening performed on under screened women (no pap smear previous 4 years).
Service Incentive Payments are paid in addition to the normal Medicare benefit for the particular items and require specific trigger MBS item numbers to be billed. SIPs are paid quarterly in February, May, August and November.
More information and a complete list of PIP payments available can be found on the Health Professional website.
Update PIP details via HPOS
PIP updating is also now available through Medicare's Health Professional Online Services (HPOS) website. Updates are immediate and can reduce the likelihood of a delay in your PIP payment. Practices that update details through HPOS have until the point in time to submit, whereas practices that submit updates via paper forms must submit the paperwork at least seven days before the relevant point in time - for example for the May quarterly payment, the point in time is 30 April.
The practice can also choose to get correspondence via HPOS –for example the practice’s annual PIP Confirmation Statement and PIP payment advices.
For individual practitioners to access PIP Online to update their own information, they need to have registered their Individual PKI certificate RA number with PIP by emailing email@example.com or firstname.lastname@example.org