Very Low Cost Access scheme

The Very Low Cost Access (VLCA) scheme supports general practices with an enrolled population of 50% or more high needs patients where the practice agrees to maintain patient fees at a low level.

The VLCA scheme was introduced in October 2006. This is a voluntary scheme that general practices can opt out of at any time if they find it is no longer appropriate for them.

Patients wanting to know if the practice they attend is part of the VLCA scheme should ask their doctor or practice nurse.

Very Low Cost Access payments

VLCA payments provide:

  • extra funding in return for PHOs and general practices agreeing to maintain fees within the fees thresholds
  • recognition of the extra effort involved in providing services to high need populations, and keeping fees low for the people who can least afford primary health care and improving health outcomes for those most likely to have the worst health.

Eligibility criteria for the Very Low Cost Access payment

From October 2009, eligibility for the Very Low Cost Access payment is limited to PHOs and contracted general practices meeting the eligibility criteria of 50% high needs population (defined as Māori, Pacific or New Zealand Deprivation Index quintile 5), and currently charging or prepared to reduce their fees to:

  • zero fees for children 0–12 years.
  • $12 maximum for children 13–17 years.
  • $18.00 maximum for adults 18 years and over.

The PHO must also have entered into the most current version of the PHO Services Agreement (where a variation to that Agreement has been made during a payment quarter, the PHO must have entered into the most current version of that Agreement by a date determined by both the DHB and the PHO). 

Case studies

In 2013 the PHO Services Agreement Amendment Protocol (PSAAP) Group contracted a case study review of five VLCA Practices.

Additional funding

In September 2013 a sustainability fund of $4 million was established to support struggling VLCA practices. Funding is allocated to PHOs, on the basis of their high needs enrolled population, for them to distribute to their VLCA practices on the basis of the issues they are facing.

Additional funding was paid available during 2013 and 2014 to fund graduate nurses to work in VLCA practices for 1 year. It is the responsibility of the practice and the PHO to manage the continued employment (if appropriate) of those nurses.

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