Adelaide PHN - An Australian Government Initiative

connecting you to health

Health Care Homes Adelaide PHN - An Australian Government Initiative

Health Care Homes

The Adelaide PHN has been selected as one of the ten regions for Stage One of the Commonwealth Government Health Care Homes Trial. All General practices and Aboriginal Community Controlled Health Services (ACCHS) in selected regions around Australia can now apply to become Health Care Homes. 

Health Care Homes will improve the provision of care for people with chronic and complex conditions in Australia’s primary health care system.  General practices and ACCHS participating in this first stage of implementation will have a vital role in shaping the future roll-out of this important reform.  

The 10 selected regions are Adelaide, Country South Australia, Perth North, Northern Territory, Brisbane North, Western Sydney, Nepean Blue Mountains, Hunter, New England and Central Coast, South Eastern Melbourne and Tasmania. 

Where can I get more information?

Identifying Patients

The Health Care Homes patient identification and risk stratification tool is currently being developed, based on the QAdmissions tool and the Hospital Admission Risk Programme (HARP). 

QAdmissions is a validated clinical risk prediction tool which can be used to assess a person’s risk of emergency hospital admission over one to two years. The tool was developed in the United Kingdom and requires some modification for the Australian population. The QAdmissions risk calculator is available here.

HARP is used to determine the overall risk of a person presenting to hospital in the next 12 months. The tool assesses presenting clinical symptoms, service access profile, self-management and psycho-social issues and classifies people into one of four categories (low, medium, high and urgent). More information on the HARP calculator is available here.

Although the Health Care Homes patient identification and risk stratification tool is not yet available, some general practices and ACCHS may already have data systems through which they can identify the likely patient cohort, based on the tier characteristics, QAdmissions and HARP. This is explained in the patient eligibility factsheet on the Health Care Homes page.

Key Dates

  • 22 December 2016: Applications for stage one of Health Care Homes close. Go to the Tenders and Grants page to apply 
  • Early 2017 — Health Care Home practices/ACCHS notified of their selection for stage one 
  • April 2017
    • training for the selected practices begins, based on modules and resources developed by Australian General Practice Accreditation Limited (AGPAL) 
    • practices can begin identifying patients for enrolment. However, patients will not be entered into HPOS until July 2017, when payments commence
  • June 2017 — Health Care Homes will be registered with Department of Human Services
  • July 2017 — Health Care Homes services start 

Frequently Asked Questions

What are the benefits in becoming a Health Care Home? 

The Health Care Homes model will provide flexibility to shape care around each patient’s needs. 

By moving to a bundled payments model, Health Care Homes will remunerate practices for the value rather than the volume of care provided. 

It also allows for team-based care, giving GPs greater flexibility and drawing on the skills of all the health professionals involved in the primary care of people living with chronic and complex conditions.  


When will the selected Health Care Homes be announced?  

Expressions of Interests close on 15th December 2016 and are expected to be announced in early 2017.


Our practice is not in one of the ten selected regions? Can we still apply to become a Health Care Home? 

All practices in South Australia can apply, Adelaide and Country SA are two of the 10 regions selected by the Commonwealth.


What are the benefits for patients if my practice becomes a Health Care Homes?

Health Care Homes will provide patients with a home base – a general practice or ACCHS – through which their chronic and complex conditions are managed.  

While each Health Care Home will be different depending on the region and community in which it is based, all Health Care Homes will be based on the medical home model. The benefits of this model for consumers include: 

  • Patient-centred care based around the patient’s needs and preferences.
  • Improved coordination of services, including links with hospitals, allied health and community care providers.
  • Improved personalised care through a more formal link with the patient-nominated clinician (usually a GP) leading the care team developing and delivering their tailored care.
  • Improved access to services, including remote support that may include phone, email or video conference where clinically appropriate.
  • A long-term approach to disease prevention and health promotion to improve health outcomes.

Similar models have already been successfully adopted in the United States of America and New Zealand. Many excellent primary care practices in Australia are also already applying the key principles of Health Care Homes.


What is the role of the Adelaide PHN in the implementation of Health Care Homes?

The Adelaide PHN is supportive of any initiative that seeks to improve outcomes for people living with chronic and complex conditions. The role of the Adelaide PHN during Stage One is still being developed, but we will play an important role in supporting the effective implementation of the program within Adelaide PHN region. We anticipate this role may include support and training for Health Care Homes.


Is Health Care Homes the same as the Care Connections?

The Adelaide PHN is currently undertaking a suite of activities called Care Connections. These activities are different and separate, but complementary to the Commonwealth Health Care Homes. Care Connections focuses on additional opportunities to explore the Patient Centred Medical Home, including the Medical Neighbourhood within the Adelaide metropolitan region.

Practices can be a Care Connection practice and a Health Care home.

For more information, please see