International Learning on Increasing the Value and Effectiveness of Primary Care (I LIVE PC) New Zealand

Felicity Goodyear-Smith; Robin Gauld; Jacqueline Cumming; Bev O'Keefe; Harry Pert; Paul McCormack

doi:10.3122/jabfm.2012.02.110198

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Table 1.

Lessons Learned from the New Zealand (NZ) Experience for US Health Reform

Value of networks	Network organizations have provided administration, budget holding, incentivized programs, data feedback, peer review, education, human relations, and HIT support and resources. Such organizations have been found to play a key role in better supporting primary care services and service development.
Population approach	NZ has successfully enrolled patients with a unique patient identifier (National Health Index) supporting this enrolment. This has allowed networks and providers to focus increasingly on achieving improved health for their enrolled population and has improved accountability through the ability to identify the population being cared for and assess progress in achieving key targets.
Clinical, community, and corporate governance	NZ has developed a mix of clinical, community, and corporate governance arrangements, although how well this mix works is not well researched.
Blended payments	NZ has successfully introduced a mix of salary, capitation, fee-for-service, and target-driven payments, although the impact of these changes is not well researched.
Interdisciplinary team approach	There is increasing teamwork between doctors, nurses, community pharmacists, other allied health workers.
HIT interoperability	Improved interoperability is gradually allowing providers to access records and will over time be available to patients as well.
Intersectorial integration	The government currently is seeking increased devolution of hospital-based services into the community to ensure “better, sooner, and more convenient” services and to reduce pressure on hospitals. The extent of devolution and its impact is not well researched.
Health outcomes	With several years of investment in organized primary care, data show some improvements in patient outcomes. These include rates of immunization; routine screening of patients at risk for cancers, cardiovascular disease, and diabetes; and care coordination of chronic disease patients, with corresponding reductions in hospitalizations.