Practice Incentives Program

The PIP Quality Improvement Incentive is a new incentive that became available from 1 August, 2019, as part of the Practice Incentives Program. It's a payment to general practices that participate in quality improvement activities to improve patient outcomes and deliver best practice care.

There are two components that a general practice needs to meet to be eligible for a PIP QI incentive payment:

1. Participate in continuous quality improvement
2. Provide the PIP Eligible Data Set to its local PHN

The PIP QI Guidelines provide further information about PIP QI.
 

The PIP Eligible Data Set is a set of ten quality improvement measures:

1. Proportion of patients with diabetes with a current HbA1c result
2. Proportion of patients with a smoking status
3. Proportion of patients with a weight classification
4. Proportion of patients aged 65 and over who were immunised against influenza
5. Proportion of patients with diabetes who were immunised against influenza
6. Proportion of patients with COPD who were immunised against influenza
7. Proportion of patients with alcohol consumption status
8. Proportion of patients with the necessary risk factors assessed to enable CVD assessment
9. Proportion of female patients with an up-to-date cervical screening
10. Proportion of patients with diabetes with a blood pressure result

Some demographic information, such as sex, ATSI status, and age (in five-year brackets) will also be collected. Please see the PIP Eligible Data Set Governance Framework for more information.
 

Practices that have been granted an exemption must commit to meeting the requirements of the exemption, as well as the ongoing requirements for eligibility for PIP QI. While these practices are required to develop, within the exemption period, a data sharing solution that complies with the PIP QI Guidelines and PIP Eligible Data Set Governance Framework. WAPHA is not yet positioned to receive these data sets as we have not yet received, from the Department of Health the technical specifications for the data sets.
 
For practices, this means that we cannot yet provide you with appropriate guidance around the extraction and submission of the PIP Eligible Data Set by means other than our preferred data extraction tool (PEN CS). Therefore, we ask that you do not send us patient or practice data until we are able to provide you with the guidelines and mechanisms to do so in a manner that meets your PIP QI eligibility requirements and, most importantly, ensures secure transmission of the data.
 
We ask that you do not send any patient or practice data to us other than via methods (such as PEN CS) that have been verified as fit for purpose and secure.
 
WAPHA will communicate with practices regarding the technical specifications as soon as these are made available to us.

 

The Royal Australian College of General Practitioners (RACGP) defines continuous quality improvement as an ongoing activity undertaken within a general practice with the primary purpose to monitor, evaluate, or improve the quality of healthcare delivered to practice patients.

 

To register for PIP QI, your practice must first be participating in the Practice Incentives Program. If your practice has not applied for PIP, this can be done online through HPOS, or by using the DHS IP001 form. 

Your application to participate in the Program must be finalised before your practice can register for the PIP QI payment.

Registration for PIP QI can then be completed via HPOS. Please note that WAPHA cannot complete your PIP QI registration on your behalf, however your Primary Health Liaison or CPC Facilitator will be able to provide you with support for this process.

Once your practice is registered for PIP QI, please let your Primary Health Liaison or CPC Facilitator know. We will need you to provide your PIP ID to us, and discuss your data sharing approach, in order for us to confirm your eligibility for the incentive.
 

Part of WAPHA's role in the PIP QI is to provide a report to the Department of Health that confirms the identity of the practices that met the eligiblity requirements each quarter. 

WAPHA must ensure that it provides the Department of Health with data that enables it to reliably identify participating practices. To do this, we need to know your practice's PIP ID, and the name your practice is known by to the Department of Human Services (this will usually match the name recorded on your certificate of accreditation). To support and confirm your ongoing eligibility, it is also useful for us to know your accreditation information, such as your accreditation provider, and the expiry date of your current accreditation.

By having this information recorded for your practice, we can utilise identifiers known to the Departments of Health and Human Services to ensure your practice receives payments each quarter.

 

The PIP QI Guidelines outline the payment information (page 6) for practices participating in PIP QI.

Eligible practices will be able to receive a maximum of payment of $12,500.00 per quarter, based on $5.00 per Standardised Whole Patient Equivalent (SWPE) per year. The table below provides some guidance on the payments available per quarter, and per annum, based on your practice's SWPE.

This information is provided as an estimate only: the payments for which your practice is eligible may differ from the calculations below.
 

SWPE	per quarter	per annum
1,000	$1,250.00	$5,000.00
2,000	$2,500.00	$10,000.00
3,000	$3,750.00	$15,000.00
4,000	$5,000.00	$20,000.00
5,000	$6,250.00	$25,000.00
6,000	$7,500.00	$30,000.00
7,000	$8,750.00	$35,000.00
8,000	$10,000.00	$40,000.00
9,000	$11,250.00	$45.000.00
10,000.00	$12,500.00	$50,000.00

Remember that four incentives (Diabetes, Cervical Screening, Asthma, and Quality Prescribing) have ceased with the introduction of the PIP QI.

The Service Incentive Payments (SIPs) associated with these terminated incentives also ceased with the introduction of the PIP QI. 

Yes. To be eligible to receive a PIP QI payment, general practices must:

1. be eligible for the PIP
2. register for the PIP QI Incentive
3. electronically submit the PIP Eligible Data Set to their local PHN (for WA practices, this is WAPHA) quarterly
4. undertake continuous quality improvement activities in partnership with their local PHN

One exception to this are Aboriginal Community Controlled Health Services (ACCHS) and other organisations funded under the Indigenous Australians' Health Programme (IAHP), which already provide data against the Aboriginal and Torres Strait Islander National Key Performance Indicators (nKPIs), within existing arrangements with the Department of Health (see FAQ below for more information).

There is a temporary exception to Item 3, whereby practices may request an exemption from the Department of Health to allow them to seek an alternative data sharing method to the one available from their PHN. More information on the exemption is available in the FAQ below.

 

WAPHA, like all Primary Health Networks nationwide, is responsible for receiving the PIP Eligible Data Set from participating local practices (for WAPHA, that is general practices in Western Australia), and for providing a report to the Department of Health that confirms the practices that successfully extracted data for the quarter.

WAPHA is also able to support practices with quality improvement activities.
 

The PIP QI exemption gives practices a limited period of time in which to establish a method of sharing the PIP Eligible Data Set with their PHN. The exemption may be sought because:

• the practice's existing Clinical Information System is unable to submit data using the PHN's data extraction tool, or
• the practice has chosen not to use the local PHN's data extraction tool

Practices that are granted an exemption must still meet certain requirements to maintain eligibility for the Practice Incentives Program, and specifically the Quality Improvement Incentive.

More information on the PIP QI exemption can be found by clicking here.

 

Aboriginal Community Controlled Health Services and other organisations funded under the Indigenous Australians' Health Programme for the delivery of primary health care services that wish to receive the PIP QI Incentive payment must:

• be eligible for the PIP
• register for the PIP QI incentive
• submit data on the National Key Performance Indicators (nKPIs) to the Department of Health
• undertake quality improvement activities within their existing arrangement with the Department of Health that focus on the nKPIs

These organisations do not need to share data with WAPHA to be eligible for PIP QI payments, but instead need to maintain their existing reporting arrangements with the Department of Health.

For more information about PIP QI and ACCHS, you can access the fact sheet by clicking here.
 

In addition to being a requirement for practices wishing to participate in the PIP QI, practices that share data with WAPHA enjoy the following benefits:

• Licences for the CAT Plus software suite at no cost to your practice
• Reports that provide your practice with de-identified data to help drive quality improvement in data quality, billing accuracy, and patient-centred care
• Personalised support and training to assist your practice in maximising the benefits of the Pen CS general practice data tools
• Support with quality improvement activities

Building a relationship with your Practice Supprt Team member provides you with a support person to assist you with a range of activities tailored to general practice, as well as up-to-date information about services and events both local to your practice, and pertinent to general practice state-, and nation-, wide.

Please contact WAPHA to be put in touch with your Primary Health Liaison, or contact your PHL directly to discuss the benefits of sharing data with WAPHA.

 

If your practice is not currently sharing data with WAPHA, and intends to participate in PIP QI, we encourage you to contact us as soon as possible.

Your practice may have a Pen CS licence and not be extracting, or may not have had the Pen CS tool installed. You may also wish to explore other methods for sharing data. Whatever your current circumstances, it is important that you get in touch promptly as the process for establishing a data sharing arrangement will take some time and coordination.

Please contact your Practice Support Team member to initiate this process.

If your practice is already sharing data with WAPHA, you are well-placed to meet the eligibility requirements for PIP QI.

You will need to provide your PIP ID to WAPHA so that we can ensure our records for your practice include the information we require for reporting to the Department of Health on your participation. If you have not already provided your PIP ID, you can do so by contacting your Practice Support Team member.

Your practice will also be asked to sign a new Data Sharing Agreement to reflect the new data extraction and governance requirements for the PIP Eligible Data Set.

To be eligible for a payment, your practice needs to register for PIP QI, then complete a successful data extraction of the PIP Eligible Data Set before the end date of the data submission period for the PIP quarter in which the practice registered (see blow FAQ for more information). Note that participation in the incentive must be approved prior to the data extraction: successful extractions that occur prior to successful PIP QI registration will be considered ineligible.

WAPHA has selected Pen CS as its preferred data extraction tool.

You can learn more about CAT Plus, and the Pen CS suite of tools for general practice, on its website.

Your Primary Health Liaison will also be able to assist you with information and training on the PEN CS tools.

Below are the Pen CS CAT Plus compatibility matrices for clinical and billing information systems:
 

Clinical information system	CAT4	Scheduler V3	Topbar
Medical Director	Yes	Yes	Yes
Best Practice	Yes	Yes	Yes
Zedmed	Yes	Yes	Yes (v26 and higher)
Genie	Yes	in beta	in beta
Specialist Complete	Yes	TBC	No
Medinet	Yes	No	No
MedTech32	Yes	No	No
MMEx	Yes	No	No
practiX	Yes	No	No
StatHealth	Yes	No	No

 

Billing information system	CAT4	Topbar
PracSoft	Yes	Yes
BP Management	Yes	Yes
Zedmed	Yes	Yes
Communicare	Yes
Mediflex	Yes
MedTech32	Yes
Medilink	Yes
MMEx	Yes
practiX	Yes
Genie
The Practice	Yes

 

The Department of Health and Primary Health Networks (PHNs) nationwide are working together to determine a solution for practices that do not currently have software that is compatible with Pen CS or POLAR GP (an alternative extraction tool in use in other PHNs).
 
PHNs, Pen CS, POLAR GP and clinical software providers are awaiting the release of the technical schema to support the PIP QI Improvement Measures. Once this is released, PHNs will have more insight into the available methods for manual extraction to support practices using non-compatible software

In the interim, a time-limited exemption is available for practices that have clinical software systems that are incompatible with CAT Plus. More information on the exemption can be found by clicking here.

 

Assuming your practice uses software that is compatible with Pen CS, CAT4 can be configured to run a data extract by location once the clinical software has been correctly configured. Pen CS refers to this as “multi location” and has successfully supported practices to provide separate and aggregated data extracts across practices with a shared server arrangement.

If your practice uses one of the software systems listed below, please review the information provided by PEN CS to ensure the software is correctly configured for collection by location:

Best Practice collection by location
Medical Director collection by location
Communicare collection by location

We will continue to add information relating to collection by location as it becomes available.

 

Practices wth a data sharing agreement with WAPHA will receive a notification to confirm:

• a successful extraction, or
• an unsuccessful extraction

Practices only require one successful extraction within the quarter to maintain eligibility for the PIP QI payment.

The PIP Eligible Data Set Data Governance Framework sets out the roles and responsibilities of all data custodians involved in the content, collection, use, access, aggregation, privacy and security of the PIP Eligible Data Set.

• Local data custodians: Participating general practices control collection, use, access, privacy and security of data at the general practice level and are designated local data custodians.
• Regional data custodians: Primary Health Networks (PHNs) aggregate and control collection, use, access, privacy and security of data at the regional level and are designated regional data custodians.
• National data custodian: A yet to be determined national provider aggregates and controls collection, use, access, privacy and security of data at the national level and is the designated national data custodian of the PIP Eligible Data Set. The PIP Eligible Data Set Data Governance Framework sets out the roles and responsibilities of all data custodians involved in the content, collection, use, access, aggregation, privacy and security of the PIP Eligible Data Set.

 

If your practice has elected not to take updates available for CAT4, you will not be automatically notified when new updates are released, and instead, you will need to check whether updates are available.

For a screenshot of the Check for Updates function, please click here.

It is always recommended that, where possible, you utilise the latest version of your clinical software and the data extraction tool. These systems are continuously updated to deliver new features and functionality, and to address security issues as they are identified. 

In understanding the process of maintaining current versions, it is important that you consult with your practice's IT provider (if you have one). It is often the case that running updates will require authentication or assistance from the practice's IT provider. To streamline the process and potentially reduce costs for the practice that may be incurred if repeated assistance is required, you should notify your IT provider of any appointments scheduled with PEN CS, and / or consult your IT provider prior to making appointments, to ensure that all necessary parties can be available when required.
 

If you are using PEN CS CAT4 as your data extraction tool, then yes, you can exclude a patient from the extraction that you submit to WAPHA.

If your patient withdraws consent for data to be shared for the purpose of the PIP QI, you can use the functionality in CAT4 to exclude them from this particular data sharing activity only. Using this features removes a patient’s data completely from any de-identified data files that CAT creates. You only need to do this once for a patient, and that patient will be excluded from all future extractions.

To find the instructions guide on how to opt a patient out of data sharing via CAT4, please click here.

Please note that this process only excludes non-consenting patients from data extracted via CAT4: it does not exclude them from other data sharing activities your practice might participate in. You may find that your clinical software has features that allow you to exclude non-consenting patients from these other activities. If other data sharing is a concern for you or your patients, please speak directly with your clinical software provider to learn more about features specific to your software.

 

WAPHA has scheduled the automated extraction dates so that extractions will coordinate with the PIP QI reporting schedule, and PIP quarters, mandated by the Department of Human Services.

This means that automated data extractions will occur between the 9th and 12th of each month. For most practices, the schedule will have little or no impact as Scheduler works remotely to extract data at a time of day convenient to the practice.

If your practice does not have Scheduler installed, please review the FAQ above relating to software compatibility and, if your software is compatible, we recommend you contact PEN CS to have Scheduler installed. If your practice software is not compatible, and you perform data extractions manually, you may wish to use this schedule as a guide for your own processes.

Please note that two weeks prior to each PIP point in time are considered a void or blackout period, and data extracted or received during that period will not be considered an eligible data set. Therefore it is imperative that data extractions occur, and data is received, prior to this period. Please see the FAQ below for information on data submission periods and points in time.
 

The Practice Incentives Program operates on a quarterly structure, with eligibility assessed on the final day of the month prior to the quarterly payment month.
 

Quarterly payment month	Point in time assessment of eligibility	Reference period
February	31 January	1 November to 31 January
May	30 April	1 February to 30 April
August	31 July	1 May to 31 July
November	31 October	1 August to 31 October

For the purpose of the PIP QI, it is important for practices to remember that there is a defined data submission period for each quarter, and only extractions received within the data submission period will contribute to the practice's payment eligibility for that quarter.

The data submission periods for PIP QI are outlined in the table below.
 

Quarterly payment month	Data submission period	Reference period
February	1 November to 15 January	1 November to 31 January
May	1 February to 15 April	1 February to 30 April
August	1 May to 15 July	1 May to 31 July
November	1 August to 15 October	1 August to 31 October

WAPHA will inform practices of the data submission cut off date for each quarter, and has designed the extraction schedule (for those with CAT4 Scheduler installed) to coordinate with the PIP reporting period and provide practices with sufficient opportunity to achieve a successful, eligible extraction.
 

The Department of Health recently released advice on the payment schedule for practices that participated in the PIP QI incentive in the first quarter (August - October 2019).

If your practice / service:

• registered by 15 October, 2019, with the Department of Human Services (DHS) to participate in PIP, and successfully submitted data to WAPHA during the eligible data submission period, or
• registered by 15 October, 2019, with DHS to participate in PIP QI, and submitted nKPI data to the Department of Health (DoH) as required under the Indigenous Australian's Health Program (IAHP), or
• registered with DHS to participate in PIP QI and had an exemption granted between 1 August and 15 October, 2019

then you can expect to receive a payment for PIP QI in the month of November, 2019.

If your practice / service:

• registered between 16 October and 31 October, 2019, with DHS to participate in PIP QI and successfully submitted data to WAPHA by 31 October, 2019, or
• registered between 16 October and 31 October, 2019, with DHS to participate in PIP QI and submitted nKPI data to the Department of Health (DoH) as required under the Indigenous Australian's Health Program (IAHP), or
• registered with DHS to participate in PIP QI and had an exemption granted between 16 October and 31 October, 2019, or
• has not been able to be included in the first tranche assessments (November 2019) due to further work being required to assess your eligibility (e.g. correction of records, review of decisions, and other exentuating circumstances)

then you can expect to receive a payment for PIP QI in the month of December, 2019.

If your practice does not receive a payment, it may also have had its payment delayed or withheld due to:

• non-compliance with eHealth incentives requirements (this can affect all PIP payments for a short time)
• expired general practice accreditation (or recent updates to accreditation status not received)
• failure to submit the annual confirmation statement

If your practice does not receive an expected PIP QI payment, or believes there are extenuating circumstances that should be considered, please direct your communication through the Department of Human Services by completing the Practice incentives review of decision form (IP027).
 

The Department of Human Services has a good range of education resources, including videos, simulations, and infographics, to help healthcare providers set up Provide Digital Access (PRODA) and Health Professional Online Services (HPOS). You will need to create a PRODA account to use HPOS, so please start with the PRODA education if you are new to DHS online services.

PRODA education resources
HPOS education resources
Incentives programs education resources

Your Practice Support Team member may also be able to provide you with assistance in using online services.
 

Yes, we can.

Firstly, please click here to download our step-by-step guide to registering for PIP QI. This PDF has images of the screens within HPOS that you should expect to see when registering for  PIP QI, and instructions on where to click.

If you stll cannot register, you can contact your Practice Support Team member for further assistance, or contact the Department of Human Services Incentives Branch.

The RACGP has released a PIP QI fact sheet, which you can download by clicking here.

The Practice Assist website provides links to a wide variety of guidelines and resources to assist you with managing data security and patient health information in general practice.

PenCS has a suite of materials designed for use in general practice and Aboriginal Medical Services.

For more information or assistance with the Practice Incentives Program:

Ph: 1800 222 032
Monday to Friday
8.30am to 5.00pm Australian Central Standard Time (7.00am to 3.30pm Perth time)

Email: pip@humanservices.gov.au