Practice Incentives Program

The Practice Incentives Program (PIP) aims to support general practice activities.


These activities include continual improvements, quality care, enhanced capacity, and improved access and health outcomes for patients.

The Practice Incentives Program (PIP) is administered by the Department of Human Services (DHS), on behalf of the Australian Government Department of Health (DoH).
 

Eligibility criteria

To be eligible to participate in the PIP, a general practice must meet all of the following requirements:

  • meet the Royal Australian College of General Practitioners (RACGP) definition of a general practice
  • meet the PIP definition of an open practice (where one or more registered medical practitioners provide face-to-face medical or health services to patients at a physical location)
  • maintain at least $10 million in public liability insurance cover for the main location and each additional practice location (legal liability is not public liability).
  • make sure all general practitioners and nurse practitioners have the required minimum of $10 million professional indemnity insurance cover
  • be accredited, or registered for accreditation, as a general practice against the RACGP Standards for general practices  by an agency approved under the National General Practice Accreditation Scheme. Accreditation must cover the entire quarter the practice is applying in and be maintained thereafter. Practices must be registered for and achieve accreditation against the RACGP Standards within 12 months of joining the PIP Program.
You can download a copy (current at September 2019) of the Practice Incentives Program Guidelines by clicking here (please note: this is a Word document).

 

Current incentives

The PIP currently comprises eight incentives. Participating practices can apply for as many or as few as are applicable to their practice. Each PIP has its own program eligibility criteria, questions and required supporting evidence. The PIP includes incentives for:

  • After Hours
  • eHealth
  • GP Aged Care Access
  • Indigenous Health
  • Procedural GP 
  • Quality improvement
  • Rural Loading 
  • Teaching


Workforce Incentive Program (WIP)

In addition, the Workforce Incentive Program (WIP) provides targeted financial incentives to encourage doctors to deliver services in rural and remote areas. The WIP also provides financial incentives to support general practices to engage the services of nurses, Aboriginal and Torres Strait Islander Health Practitioners and Health Workers, and eligible allied health professionals. For more information please see our WIP Information page.

On 24 April 2020, the Department of Health and Services Australia provided an update regarding the Practice Incentives Program (PIP) and Workforce Incentive Program (WIP), in response to COVID-19 to support general practice.

For further information please review the PIP and WIP – updated COVID-19 Business Continuity Arrangements from the Department of Health.

 

1. What is the PIP QI?

The PIP Quality Improvement Incentive 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.
 

2. What is continuous quality improvement?

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.

3. How do I contact the Department of Human Services Incentives Branch?

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
 

1. How can I register my practice for PIP QI?

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 our Practice Support Staff  will be able to provide you with support for this process.

Once your practice is registered for PIP QI, please let your WAPHA Practice Support Staff member know.
 

2. What information does my practice need to provide to WAPHA for the purpose of PIP QI?

We collect from general practice:
  • PIP ID + HPOS screenshot (the screenshot is to validate the PIP ID provided)
  • PIP registration name
  • Clinical information server status (shared server vs independent onsite server)
  • Standalone practice or satellite practice
We will need you to provide your PIP ID, and discuss your data sharing approach, in order for us to complete the set up for the incentive.
 

3. I am unsure how to set up PRODA and HPOS: can you help me?

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

4. Why does WAPHA need my PIP ID?

Part of WAPHA's role in the PIP QI is to provide a report to the Australian Government Department of Health that confirms the identity of the practices that met the Data submission 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).
In addition to registration for PIP QI, WAPHA collects and stores 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 Department of Health and Department of Human Services to guide your practice on the requirements.

5. I am having trouble working out how to register for PIP QI in HPOS: can you help?

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

6. How much money will my practice receive for participating in PIP QI?

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 PIP 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. 

7. What do Aboriginal Community Controlled Health Services (ACCHS) need to do to receive the PIP QI payments?

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.
 

8. How do the PIP quarters, "points in time" and data submission periods work?

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 notify practices who share data via Primary Sense if there is an issue with their extractions that may impact on submissions for the PIP Quarter. Practices can ensure correct function of the extractions by checking the performance dashboard within the Primary Sense tool.  Practices who share data via the WAPHA Data Upload Facility (JSON file) will receive an email invitation to submit their data each quarter. 

 

9. My practice has not received its PIP QI payment: what should I do?

If your practice does not receive a payment but all data sharing and other PIP QI eligibility requirements have been met, it may 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).

 

10. How do I withdraw my practice from participation in PIP QI?

General practices, ACCHS and other IAHP organisations can withdraw from the PIP QI Incentive online through HPOS by the data submission period end date for the relevant quarter. General practices, ACCHS and other IAHP organisations can re-apply at any time for the PIP QI Incentive online through HPOS.
 

1. What is the PIP Eligible Data Set?

The PIP Eligible Data Set is the data that general practices must provide to their local PHN for the purposes of PIP QI. The PIP Eligible Data Set is comprised of only those fields required to calculate the PIP QI ten improvement measures, and conduct approved analysis in accordance with the PIP Eligible Data Set Governance Framework.

The ten quality improvement measures are:
  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
The PIP Eligible Data Set is de-identified patient data, aggregated at the practice level.

 

2. What will the PIP Eligible Data Set – and therefore my practice’s data – be used for?

Under the guidelines of the program, the PIP Eligible Data Set can only be used for the purposes of:
  1. Improving the quality of care and patient outcomes
  2. Improving the capacity for general practices to benchmark their activities against peers on an agreed set of improvement measures
  3. Providing nationally consistent, comparable data against specified quality improvement measures to create regional and national health data sets
  4. Contributing to service planning and population health mapping at different levels including PHN boundaries, local health districts, jurisdictional boundaries, and national, and
  5. Confirming participant eligibility for the receipt of Commonwealth funding under the PIP QI incentive.

1. Does my practice have to share data with WAPHA to be eligible for 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.

2. My practice IS currently sharing data with WAPHA but is not registered for PIP QI - what do I need to do?

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 the Practice Assist Team.

Your practice will also be asked to sign a Data Sharing Agreement (DSA) to reflect the 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. 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.
 

3. My practice IS NOT currently sharing data with WAPHA but would like to participate in PIP QI - what do I need to do?

If your practice is not currently sharing data with WAPHA, and intends to participate in PIP QI, we encourage you to contact Practice Assist as soon as possible because the process for establishing a Data Sharing Agreement (DSA) will take some time and coordination.

Please contact the Practice Assist Team to initiate this process.

4. What data extraction tool does WAPHA use?

WAPHA's data extraction tool of choice is Primary Sense.

Primary Sense is a clinical decision support, population health management and data extraction tool for extracting, analysing and managing general practice data in a confidential and safe way.

For detailed information, visit the Practice Assist Primary Sense Tool Kit webpage.

5. Which general practice clinical software systems are compatible with Primary Sense?

Primary Sense is available to general practices that use Best Practice or Medical Director as a clinical information system (CIS), with more clinical software systems soon to become compatible.

Contact the Practice Assist Team to find out more.

6. My practice was granted an exemption from sharing data for the purpose of PIP QI - what do I need to do now?

As the exemption period ended on 31 July 2020, your practice now needs to begin sharing the PIP QI Eligible Data Set each quarter with WAPHA. Please contact the Practice Assist Team to initiate this process.

7. What if my practice uses software that is not compatible with Primary Sense?

Please contact the Practice Assist Team to discuss your options or refer to the Primary Sense and Data Sharing Options fact sheet.
 

8. With Primary Sense, where is the extracted de-identified data stored?

Data is de-identified and encrypted when it is extracted before it is forwarded to the database. Extracted de-identified data is stored in the Primary Sense Database, which is located in the cloud-based Microsoft Azure, in Australia. For further information, refer to FAQ 10.

9. What does de-identified data mean?

PHNs are unable to accept identifiable data from practices. Identifiable patient information such as names and Medicare numbers are removed from data to make it de-identified before it is sent to PHNs. With Primary Sense, only practices can see patient identifiable data while using their computers and servers. No identifiable data leaves the practice.

10. What standards of data security are used by Primary Sense?

Primary Sense uses the highest standards of data security to extract, analyse and manage general practice data. All data transmission is encrypted and sent over secure channels. It is stored or contained in reports that are locked down under multiple layers of access control.

Data Sharing Agreements between each general practice and its PHN specify what data is being extracted and what purposes it can be used for. Data is governed responsibly, privacy protected and securely stored and managed in Australia by the PHN-owned Primary Health Insights (PHI) hosting platform. PHI has been developed using the following guiding principles:

  • Patient privacy, data and cyber security are critical and a fundamental part of the platform.
  • Data governance processes are best practice and fit for purpose.
  • PHNs maintain full control of the data held on the platform.
The platform features multiple layers of security and a comprehensive governance framework. It complies with the Australian Privacy Principles and legislation.
 

11. What changes have been made to WAPHA’s Data Sharing Agreement (DSA)?

With Primary Sense as WAPHA’s data extraction tool of choice, amendments to the Data Sharing Agreement (DSA) have been made which still align with the Commonwealth’s own DSA template for the extraction and use of clinical practice data.

The Explanatory Note below provides a summary of the key terms of the Data Sharing Agreement (Primary Sense) and to address potential queries that may be raised in your use of the Primary Sense Software (Software).

12. What is the PIP Eligible Data Set Data Governance Framework?

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: The Australian Institute of Health and Welfare (AIHW) 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.

13. I have patients who don't want their data shared - can they opt out?

General practices are required to adhere to privacy principles when sharing de-identified data. Generally, this is included in the patient registration form and patients can opt out at any time.

Primary Sense has a quick and easy patient opt out function for this purpose.

14. How can my practice upload the PIP Eligible Data Set JSON file via the WAPHA Data Upload Facility?

For practices that wish to participate in PIP QI and share a compliant data extract file (JSON) from their clinical information system, a secure WA Primary Health Alliance Data Upload Facility (“Data Upload Facility”) has been developed by WAPHA.

Practices will require a signed Data Sharing Agreement (DSA) to share data using this solution. If this is not the current method in which you share data, but you wish to implement this method, please contact the Practice Assist Team to establish a new DSA.
 
For practices that have signed a DSA to data sharing using the upload solution via Data Upload Facility, please find the relevant documents below: To be eligible for a payment, your practice needs to register for PIP QI, then complete a successful data extraction and upload of the PIP Eligible Data Set before the end date of the data submission period for the PIP quarter in which the practice registered. 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.
 

1. What is WAPHA's role in the PIP QI program?

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 will share the de-identified aggregated data with the national data custodian – the Australian Institute of Health and Welfare (AIHW) – for national level analysis and research.

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

2. What are the benefits of sharing data with WAPHA? What can WAPHA help with?

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:
  • A licence for the Primary Sense data tool at no cost.
  • Reports that provide de-identified data to help drive quality improvement in data quality, billing accuracy and patient-centred care.
  • The opportunity to increase practice revenue through better practice insights.
  • The ability to strengthen patient care using insight-based decision making.
  • Personalised support and training to assist with maximising the features and benefits of the Primary Sense data tool.
  • Support with quality improvement activities.
Contact the Practice Assist Team to discuss the benefits of sharing data with WAPHA.

3. Are there any other resources that I can access?

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

The Practice Assist RACGP Standards and Other Resources Tool Kit webpage provides links to a wide variety of guidelines and resources to assist you with managing data security and patient health information in general practice.

For more information about the Primary Sense data tool, visit the Practice Assist Primary Sense Tool Kit webpage.
Practice Assist acknowledges and pays respect to the Traditional Owners and Elders of this country and recognises the significant importance of their cultural heritage, values and beliefs and how these contribute to the positive health and wellbeing of the whole community.

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While the Australian Government Department of Health has contributed to the funding of this website, the information on this website does not necessarily reflect the views of the Australian Government and is not advice that is provided, or information that is endorsed, by the Australian Government. The Australian Government is not responsible in negligence or otherwise for any injury, loss or damage however arising from the use of or reliance on the information provided on this website.