The Shared Care Programme (Programme) is one of the pilot programmes launched by the Government, through the Hospital Authority (HA), to enhance primary care services to strengthen the management of chronic diseases and enhance support for chronic disease patients through multi-disciplinary and cross-sector collaboration with a view to reducing complications and the need for hospitalisation. The Programme aims to test a service model for public-private shared care for chronic disease patients in the primary care settings, provide patients with choices of private services outside the public healthcare system and establish long-term patient-doctor relationships in order to achieve the objective of continuous and holistic care.
The Programme has been officially launched on 8 March 2010 at Sha Tin and Tai Po districts in the New Territories East Cluster (NTEC) of HA. Invitations have been sent out to private medical practitioners (PMPs) practising in Sha Tin and Tai Po districts and eligible patients since May and July 2010 respectively. The Programme was then rolled out to the Hong Kong East Cluster (HKEC) of HA in September 2010.
In the initial stage, the Programme will primarily target at diabetes mellitus with or without hypertension (DM ± HT) patients who are currently taken care of by the public healthcare system. They must have started to receive care for DM ± HT at public Specialist Outpatient Clinics (SOPCs) of HA , including those previously received care at public SOPCs but have been referred to Family Specialist Medicine Clinics (FMSCs) or General Outpatient Clinics (GOPCs) for continuous follow-up; and be assessed to be clinically stable through the Comprehensive Risk Assessment provided by HA. Eligible patients are free to choose whether to join the Programme for shared care by both the public and private sectors or to continue to receive care in the public sector.
During the pilot period, the Government will provide each participating patient with a maximum subsidy/ incentive of $1,600 per year. Of which, the Government will deposit up to $1,400 subsidy per year in form of electronic health vouchers into an electronic healthcare voucher account created for each participating patient, covering a subsidy of $1,200 for at least 4 consultations/case management per year at an interval of not more than 4 months apart and drugs for treating DM ± HT; and an incentive of up to $200 per year for patients who can meet the preset health outcome indicators and complies with the care requirements prescribed by their PMPs.
To encourage PMPs to provide treatment to patients to meet specified process indicators (e.g. measuring blood pressure and body weight and conducting annual health risk assessment), the Government will provide quality incentive of $200 each year to participating PMPs for each patient under his/her care in the Programme. PMPs must meet all process indicators in order to receive the payment.
Participating PMPs are required to publicise upfront the fees that they expect to charge each patient per year for treating DM ± HT on top of the subsidy amount. On top of the subsidy, participating patients have to pay out-of-pocket the fee listed by PMPs for providing services for treating DM ± HT according to specified care model and clinical protocols, as well as the fee for any other additional (not subsidised) services. Elders who are aged 70 or above and have participated in the Elderly Health Care Voucher Pilot Scheme can use the subsidy provided under the Programme together with their elderly health care vouchers when they receive consultations.
Laboratory services and annual Comprehensive Risk Assessment related to the management of DM or HT will be provided by HA as specified in the evidence-based clinical protocols and through PMPs’ referral. Should patients’ conditions deteriorate or if specialist assessment is required due to other problems, PMPs can refer the patients to public outpatient clinics for timely management as appropriate through the Support Office.