Primary Health Care

Care Plus

What is Care Plus?
Who is eligible for Care Plus?
How is Care Plus different?
Care Plus and the High User Health Card?
Care Plus Evaluations
Care Plus Funding

What is Care Plus?

Care Plus is a primary health care initiative targeting people with high health need due to chronic conditions, acute medical or mental health needs, or terminal illness. Care Plus aims to improve chronic care management, reduce inequalities, improve primary health care teamwork and reduce the cost of services for high-need primary health users.

Care Plus was piloted in three PHOs during 2003/04 - HealthWEST PHO in West Auckland (Waitemata DHB); Tihewa Mauriora PHO in Kaikohe (Northland DHB); Canterbury Community PHO (Canterbury DHB). The programme was rolled out nationally on 1 July 2004.

Who is eligible for Care Plus?

A person is eligible for Care Plus if they are enrolled in a PHO and they are assessed by a doctor or nurse at their general practice as being able to benefit from ?intensive clinical management in primary health care? (at least two hours of care from one or more members of the primary health care team) over the following six months, and either:

Has two or more chronic health conditions, so long as each condition is one that:
- Is a significant disability or has a significant burden of morbidity; and
- Creates a significant cost to the health system; and
- Has agreed and objective diagnostic criteria; and
- Continuity of care and a primary health care team approach has an important role in management; or
Has a terminal illness (defined as someone who has advanced, progressive disease whose death is likely within 12 months); or
Has had two acute medical or mental health-related admissions in the past 12 months (excluding surgical admissions); or
Has had six first-level service or similar primary health care visits in the past 12 months (including emergency department visits); or
Is on active review for elective services.

If you think you may be eligible for Care Plus, ask your doctor or nurse if they are offering the services. They will assess you to see if you are eligible for Care Plus. If you are not eligible it may be that they can help you in other ways or review your existing care.

How is Care Plus different?

The delivery of Care Plus varies between PHOs, and in some cases it varies between practices within the same PHO. In general, a Care Plus patient can expect an initial comprehensive assessment, where their health needs are explored in more depth. An individual care plan will be developed to set realistic, achievable health and quality of life-related goals, with regular follow-ups. People using Care Plus will get effective management of chronic health conditions, better understanding of their conditions and support to make lifestyle changes. Care Plus services are provided at a low or reduced cost.

Care Plus and the High Use Health Card

Is Care Plus replacing the High User Health Card?
Over time, Care Plus will replace the High Use Health Card (HUHC) as the means of targeting high-needs patients. Care Plus differs from the HUHC, in that it coordinates a comprehensive approach to improve outcomes for people with chronic conditions, including lower cost access, whereas the HUHC is a subsidy approach tied to GP visits.

Will High User Health Card patients automatically transfer to Care Plus?
When HUHC patients come for their annual review, they should be assessed to see whether they are eligible for Care Plus. If they are, they will be transferred.

Care Plus Evaluations

Evaluations of the Care Plus Programme have been completed by CBG Research Ltd.

Go to the Care Plus Evaluation pages

Care Plus Funding

Overall funding allows for five percent of the New Zealand population to be Care Plus patients. Care Plus funding is based on a capitation formula, and the level of funding paid to PHOs is dependent on the percentage of the eligible number of Care Plus patients receiving Care Plus services. The level of funding that a PHO receives increases as the PHO enrolls more Care Plus patients.

Read more about Care Plus funding

Page last updated: 10 October 2007