Capitation Rates - Funding - Primary Health Care

NZ Ministry of Health Web Page
Printed 11/26/2009 04:29:25 PM Back Print

Primary Health Care
Capitation Rates from 1 July 2009

All rates exclude GST and are annualised amounts

First Level Health Services by Access Practices for Enrolled Persons

Access First Contact		HUHC
Age Group	Gender	N	Y
00-04	F	$364.6896	$545.1456
	M	$383.9668	$545.1456
05-14	F	$115.4364	$349.5348
	M	$108.0500	$349.5348
15-24	F	$106.5176	$336.7076
	M	$58.6244	$336.7076
25-44	F	$93.6012	$336.7076
	M	$60.5056	$336.7076
45-64	F	$128.2044	$368.7748
	M	$95.7548	$368.7748
65+	F	$220.9344	$395.4980
	M	$190.5308	$395.4980

First Level Health Services by Non-Access Practices for Enrolled Persons

Non-Access First Contact		HUHC
Age Group	Gender	N	Y
00-04	F	$355.8980	$545.1456
	M	$378.7244	$545.1456
05-14	F	$91.6292	$349.5348
	M	$86.8424	$349.5348
15-24	F	$106.5176	$336.7076
	M	$58.6244	$336.7076
25-44	F	$93.6012	$336.7076
	M	$60.5056	$336.7076
45-64	F	$128.2044	$368.7748
	M	$95.7548	$368.7748
65+	F	$220.9344	$395.4980
	M	$190.5308	$395.4980

Payments to Practices not Signed up to 25-44 Year or 45-64 Year Age Group Roll-outs

Note: If the PHO or practice has not signed up to the 25-44 year age group or the 45-64 year age group roll-outs they will get the previous capitation rates for these age groups plus an additional 2.798%. The adjustment will be via manual adjustment as has been the case for the last 2 years.

Practice not signed to roll-out			HUHC
Age Group	Gender	CSC	N	Y
25-44	F	Y	$91.1672	$336.7076
	F	N	$72.3144	$336.7076
	M	Y	$57.8432	$336.7076
	M	N	$47.0868	$336.7076
45-64	F	Y	$121.7780	$368.7748
	F	N	$99.6836	$368.7748
	M	Y	$91.4396	$368.7748
	M	N	$74.5780	$368.7748

Health Promotion Services

Health Promotion	Non High Use Health Card Holders
Health Promotion	Maori/Pacific	Non Maori/Non Pacific
Deprivation deciles 1-8	$2.5684	$2.1404
Deprivation deciles 9 -10	$2.9964	$2.5684

Services to Improve Access for High Need Groups

		Non High Use Health Card Holders




Services to Improve Access		Maori/Pacific		Non Maori/Non Pacific
Age Group	Gender	Deprivation deciles 1 - 8	Deprivation deciles 9 - 10	Deprivation deciles 1 - 8	Deprivation deciles 9 - 10
00-04	F	$72.9380	$145.8760	$0.0000	$72.9380
	M	$76.7928	$153.5872	$0.0000	$76.7928
05-14	F	$23.0868	$46.1740	$0.0000	$23.0868
	M	$21.6104	$43.2196	$0.0000	$21.6104
15-24	F	$21.3032	$42.6068	$0.0000	$21.3032
	M	$11.7248	$23.4500	$0.0000	$11.7248
25-44	F	$18.7200	$37.4412	$0.0000	$18.7200
	M	$12.1012	$24.2020	$0.0000	$12.1012
45-64	F	$25.6404	$51.2816	$0.0000	$25.6404
	M	$19.1512	$38.3020	$0.0000	$19.1512
65+	F	$44.1868	$88.3736	$0.0000	$44.1868
	M	$38.1068	$76.2124	$0.0000	$38.1068

Care Plus Services
$244.0852

Fees for Administering Vaccine Episodes

Childhood immunisation	$18.48
Influenza immunisation	$18.48
MeNZB Immunisation	$18.48

Rural Workforce Retention

Rural ranking score	Rate per capita
35-40	$7.72
45-50	$11.60
55-65	$15.46
70+	$19.31

Management Services

If the number of Enrolled Persons in the PHO is 40,000 or below and the DHB has approved the PHOs’ Management Services Plan then the rate will be $15.5928 per person up to 20,000 and $0.8992 per person from 20,001 to 40,000.
Otherwise, if the number of Enrolled Persons in the PHO is 75,000 or below the rate will be $11.0960 per person up to 20,000 and $5.3960 per person from 20,001 to 75,000
If the number of Enrolled Persons in the PHO is 75,001 or above then the rate will be $518,700.00 plus $6.0596 per person over 75,000 enrolees.

For more information, contact your District Health Board and/or view your PHO Agreement

Very Low Cost Access Payment
Individual practice component of payment available to each eligible PHO practice – annual rates

Age Group	Gender	Annual rate
00-04	F	$87.0571
	M	$91.6584
05-14	F	$27.2812
	M	$25.5356
15-24	F	$25.1458
	M	$13.8395
25-44	F	$22.0965
	M	$14.2835
45-64	F	$30.2652
	M	$22.6049
65 +	F	$52.1559
	M	$44.9786

Whole of PHO component of payment available to a PHO when all its practices are eligible – annual rates for 2009 Q3 and Q4

		Non-Maori/ Pacific		Maori/Pacific
Age Group	Gender	Deprivation Deciles 1 - 8	Deprivation Deciles 9 - 10	Dep decile 1-8	Dep decile 9-10
00-04	F	$0.0000	$15.0983	$15.0983	$30.1971
	M	$0.0000	$15.8966	$15.8966	$31.7932
05-14	F	$0.0000	$4.7606	$4.7606	$9.5212
	M	$0.0000	$4.4559	$4.4559	$8.9118
15-24	F	$0.0000	$4.3910	$4.3910	$8.7817
	M	$0.0000	$2.4168	$2.4168	$4.8333
25-44	F	$0.0000	$3.8584	$3.8584	$7.7172
	M	$0.0000	$2.4942	$2.4942	$4.9884
45-64	F	$0.0000	$5.2846	$5.2846	$10.5697
	M	$0.0000	$3.9471	$3.9471	$7.8946
65+	F	$0.0000	$9.1076	$9.1076	$18.2148
	M	$0.0000	$7.8544	$7.8544	$15.7084

Whole of PHO component of payment available to a PHO when all its practices are eligible – annual rates for 2010 Q1

Annual rates		Non-Maori/Pacific		Maori/Pacific
Age Bands	Gender	Dep decile 1-8	Dep decile 9&10	Dep decile 1-8	Dep decile 9&10
00-04	F	$0.0000	$7.5492	$7.5492	$15.0986
	M	$0.0000	$7.9483	$7.9483	$15.8966
May-14	F	$0.0000	$2.3803	$2.3803	$4.7606
	M	$0.0000	$2.2280	$2.2280	$4.4559
15-24	F	$0.0000	$2.1955	$2.1955	$4.3909
	M	$0.0000	$1.2084	$1.2084	$2.4167
25-44	F	$0.0000	$1.9292	$1.9292	$3.8586
	M	$0.0000	$1.2471	$1.2471	$2.4942
45-64	F	$0.0000	$2.6423	$2.6423	$5.2849
	M	$0.0000	$1.9736	$1.9736	$3.9473
Over 65	F	$0.0000	$4.5538	$4.5538	$9.1074
	M	$0.0000	$3.9272	$3.9272	$7.8542

Whole of PHO component of payment available to a PHO when all its practices are eligible – annual rates for 2010 Q2

Annual rates		Non-Maori/Pacific		Maori/Pacific
Age Bands	Gender	Dep decile 1-8	Dep decile 9&10	Dep decile 1-8	Dep decile 9&10
00-04	F	$0.0000	$3.7746	$3.7746	$7.5493
	M	$0.0000	$3.9742	$3.9742	$7.9483
May-14	F	$0.0000	$1.1902	$1.1902	$2.3803
	M	$0.0000	$1.1140	$1.1140	$2.2280
15-24	F	$0.0000	$1.0978	$1.0978	$2.1954
	M	$0.0000	$0.6042	$0.6042	$1.2083
25-44	F	$0.0000	$0.9646	$0.9646	$1.9293
	M	$0.0000	$0.6236	$0.6236	$1.2471
45-64	F	$0.0000	$1.3212	$1.3212	$2.6424
	M	$0.0000	$0.9868	$0.9868	$1.9737
Over 65	F	$0.0000	$2.2769	$2.2769	$4.5537
	M	$0.0000	$1.9636	$1.9636	$3.9271

Zero Fees for Under Six Year Olds Payment

Age Bands	Gender	Annual Rate
00-04	F	$65.2926
	M	$68.7441
05-14	F	$2.0462
	M	$1.9150
15-24	F	$0.0000
	M	$0.0000
25-44	F	$0.0000
	M	$0.0000
45-64	F	$0.0000
	M	$0.0000
Over 65	F	$0.0000
	M	$0.0000

Page last updated: 14 October 2009