The amendments introduced on 1 December 2018 led to negotiations by the PHO Services Agreement Amendment (PSAAP) Protocol Group. This group negotiates the national agreement on the financing and provision of primary services and includes PHOs, contract providers (mainly general practices), DHBs and the Ministry of Health26 With the introduction of capital financing, fees for practices financed by the access formula have been limited and practices funded under the interim formula have had to reduce their supplements by a mandatory amount. 8 with the consequence that the existing difference in remuneration for non-access practices is maintained before the implementation of the strategy. The agreement provides for an independent statement on “appropriate tariff increases”, which sets a maximum annual increase in surcharges on a percentage basis10 Funding for Capitation (a form of demographic funding for basic services) has been used to some extent in New Zealand since the 1940s and after the implementation of the basic services strategy11-13. primary health care has been the main funding mechanism for PHOs. PhO capita funding formulas have been described in more detail elsewhere,7,14-17, and as noted above, changes to formulas since the first implementation of the primary care strategy have been incremented and scalable. Some of the key milestones in the capitation formula over the past 18 years are shown in Table 1. Pho must also have entered into the most recent version of the PHO Service Agreement (if a change to this Agreement has been made during a payment quarter, PHO must have finalized the most recent version of this Agreement by a date set by both DHB and PHO). For more information, see Updates on Extending Access to Primary Services. . Recently, widely divergent views have been expressed on the consequences of the introduction of CCS into First Contact funding formulas.
For example, according to a spokesman for the Ministry of Health, the CCS initiative aims to remove financial barriers for low-income New Zealanders, and the ministry expects about 75% of Māori to have access to lower supplements once the initiative is fully implemented27. that there will be significant differences in the practical funding of Māori depending on the person`s status in CCS. A contrary view has therefore been expressed, indicating that funding changes will not and will not resolve inequalities between Māori and Pasifika.27,37 It has also been found that the use of CCS to target subsidies for bureaucratic and other reasons will not and will not solve.27,37. . . . Table 1: Selected Milestones of the Practical Funding Formula/PHO.7,13,14,17,19-23 The inclusion of these new funding agreements was estimated at 85% of non-VLCA practices as of 1 January 2019.29. . .