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3. As it is important to assess whether the Scheme’s contracting terms and criteria are
evidence-based, regular evaluations should seek to incorporate
population-level health data into analyses of the Scheme’s cost-
efficiency and cost-effectiveness.

4. The Government and purchaser should work towards streamlining
administrative requirements and preventing any increases in administrative
workload of private sector providers, which have been identified as a disincentive for
private family physician participation in the GOPC-PPP (Chapter 3).

5. To ensure that payment to providers is sufficiently attractive and streamlined to sustain
their participation in the scheme, the Government should create and disseminate
clear guidelines and information on their payment mechanism to
providers, including the reimbursement rate for specific services, and
ensure that mechanisms are in place for the smooth transfer of payment upon
the provision of services. As an example, the following price and reimbursement
principles should be referenced to:

a. Regarding the population-wide screening initiative for HDH, screening services
should be fully subsidised for all patients to cover the cost of services,
subject to change by demand volume. The Government and purchaser should
attempt to lower the standard pricing for screening given the
higher volume of demand once the Scheme is implemented on a
population-wide level, thus allowing the health system to achieve economies
of scale.

b. To conduct the follow-up management necessary for maintaining the health of
patients, we recommend that the Government clearly define its payment
scheme for the care of co-morbid conditions and conditions
beyond HDH. In particular, to adequately share risk between the public and
private sectors, the Government and the purchaser could offer an age-specific
and evidence-based annual subsidy to conduct follow-up
consultations and provide management for patients’ HDH. The
reimbursement rate may change depending on healthcare needs of patients.

c. To better promote the holistic care and management of health conditions, the
Government could offer an additional annual subsidy that at least
matches the GOPC-PPP subsidy value (set at HKD 3,500 at the time of
writing) to all patients diagnosed with HDH to access services that may
improve their health, such as appointments with dietitians, physical therapists, and
exercise-related services, so that patients facing financial barriers will not be
excluded. The Government and the purchaser should specify which services
are accessible with the subsidy and provide clear guidelines for the
access thereof.

d. Regarding the risk-assessment for diagnosed HDH conditions, the
Government and the purchaser could recruit allied health professionals to
conduct the risk assessments using current RAMP protocols and
to provide further patient-specific management advice. We propose
that the Government consider a standard reimbursement rate for all patients (with
the rate set to HKD 250 within the economic analysis in Chapter 4.3), subject to
future change.

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