Primary health organizations (PHOs) provide essential health care services, most often through general practices, to people registered with the PHO. Phos are funded by think-good people (DHBs) that focus on the health of their population. With the introduction of guarantee funding, Access-funded firms were capped, and interim-sponsored practices were required to reduce their co-payments by a mandatory amount8, so that differences prior to the implementation of the strategy were maintained with respect to fees for non-access practices. The annual supplement plan is defined in the PHO9 service agreement. The agreement provides for an independent list of „reasonable rate increases,“ which sets a maximum annual increase in co-payments on a percentage basis.10 Guarantee funding (a form of population-based primary procurement funding) has been used to some extent in New Zealand since the 1940s 111 and 13. , after the implementation of the primary health care strategy, which was the predominant funding mechanism for PhOs. Pho head funding formulas have been described in more detail elsewhere7,14-17 and, as noted above, changes to formulas since the first implementation of the primary health care strategy are incremental and scalable. Some of the key policy steps of the past 18 years are included in Table 1. A PHO provides primary health care, either directly or through its mandated providers. The proposed services aim to improve and preserve the health of the PHO registered population to ensure that general practice services are linked to other health services, in order to ensure a smooth continuum of care. The amendments introduced on December 1, 2018 are due to negotiations of 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), DBS and the Ministry of Health26. CCS ownership is an important new factor in the eligibility of affordable access to primary care for many people.
Because funding changes are complex, capital effects can only be fully understood when other detailed modelling is done and specific questions are answered. . In recent times, there have been widely differing views on the implications of the introduction of CCCs in First Contact`s funding formulas. For example, a statement from a Ministry of Health spokesperson indicates that the CSC initiative aims to remove financial barriers for low-income New Zealanders, and the ministry expects that approximately 75% of Maori implementing the initiative will have access to lower co-financing.27 Although more Maori may have access to lower co-financing, the head/head rates in Table 2 show that there are significant differences in practical funding for status.