Provision of a risk stratification tool including software and technical support

The Health Care Home model aims to provide a ‘home base’ to coordinate ongoing comprehensive care for people with chronic and complex conditions. Eligible patients will voluntarily enrol with a participating medical practice known as their Health Care Home.This will usually be a general practice or Aboriginal Medical Service.

A risk stratification approach (developed by the Supplier) deployed through Health Care Homes will determine patients’ eligibility for the programme on the basis of their disease complexity and predicted demand for unplanned acute care services over the next 12-months.A two-step process will be used. The first, using an implementation of the QAdmissions ® Risk Calculator algorithm, will determine potential eligibility at the practice level. The second step will be done in consultation with the patient where eligibility and risk tier will be determined using the Hospital Admission Risk Profile (HARP) questionnaire.