A Medicare overhaul is set to introduce a tiered system for people with chronic diseases that would see the most unwell patients receive $1795 in GP visits to manage their condition.
But doctors who have championed the revolutionary model say the government appeared to be cost-cutting, and it could fail from a lack of funding, leaving patients worse off.
The first detailed blueprint of the government's cornerstone Health Care Homes trial shows a monthly bundled payment will replace the individual fee-for-service Medicare payments that GPs can claim for each visit to manage patients with chronic and complex health conditions.
The sicker the patient, the bigger the bundle, with those deemed to have a high risk chronic condition and complex needs – estimated to be 1 per cent of the population – attracting an average payment of $1795 a year.
Patients with multiple chronic diseases and moderate needs would receive $1267 in benefits, and people with multiple chronic conditions largely self-managed are eligible for $591.
"At the heart of stage one is an attempt to address common patient concerns that there is fragmented care being delivered under existing arrangements and we are looking at delivering Medicare in a more flexible and targeted way to co-ordinate clinical resources to meet patient needs," a spokesperson for Health Minister Sussan Ley said.
More than $100 million has been allocated for stage one of the trial, aiming to recruit 65,000 patients in 200 medical practices in 10 regions nationally, including Nepean-Blue Mountains and western Sydney.
General practices and Aboriginal community-controlled health services involved in the trial will receive a one-off payment of $10,000.
Patients enrolled in the trial will only have access to Medicare funding for up to five general practice visits that are not related to their chronic illness, according to information published on the Department of Health website on Friday. Under the current Medicare system patients have uncapped access to GP care.
A spokesperson for Ms Ley said the cap "is an indicative figure for modelling and planning purposes and no patient's access to Medicare will be restricted or capped".
The Royal Australian College of General Practitioners and the Australian Medical Association say the overall funding fell seriously short and criticised the suggestion that patients would need only five consultations for non-chronic disease.
"It sounds more like a cost-cutting exercise or a defunding exercise, and that's the last thing we need if we are to have a sustainable healthcare system that provides quality healthcare for patients," RACGP president Dr Bastian Seidel said.
"It's really difficult to see what patients gain. For our patients, I can't see a major benefit compared to the current system," he said.
AMA vice-president Dr Tony Bartone said the proposed funding level would be "quite inadequate" to meet the complex needs of people with chronic conditions.
"We're concerned that the trial will fail and it's too important an initiative to fail," Dr Bartone said.
The two-year trial will begin on July 1 next year.
The spokesperson for Ms Ley said "it should be remembered, this is stage one of a trial. Evidence collected during this stage of the trial, including the number of allied health consultations, will be reviewed and will help inform further development of the Health Care Homes model."