All web-based NES services built into the PMS are available as soon as they have applied the upgrade version of the corresponding PMS provider and have activated the service. With the introduction of guarantee funding, Access-funded firms were capped, and interim-sponsored practices were required to reduce their co-payments by a mandatory amount8, so that differences prior to the implementation of the strategy were maintained with respect to fees for non-access practices. The annual supplement plan is defined in the PHO9 service agreement. The agreement provides for an independent list of “reasonable rate increases,” which sets a maximum annual increase in co-payments on a percentage basis.10 Guarantee funding (a form of population-based primary procurement funding) has been used to some extent in New Zealand since the 1940s 111 and 13. , after the implementation of the primary health care strategy, which was the predominant funding mechanism for PhOs. Pho head funding formulas have been described in more detail elsewhere7,14-17 and, as noted above, changes to formulas since the first implementation of the primary health care strategy are incremental and scalable. Some of the key policy steps of the past 18 years are included in Table 1. As of July 1, 2015, there is a central group of NES services of the ministry. Firms can access these services and use them as soon as PMS versions are available with the new integration feature and implemented in practice.

This will be done in a managed deployment from August 2015. Eligibility concerns the right of a patient to receive publicly funded health services. If a patient registers, users can investigate whether the patient is a Certified Birth Citizen, i.e. a patient was born in New Zealand before 2006, they are considered eligible. This will be the first aptitude assessment available. Additional information on eligibility assessment is added over time. The amendments introduced on December 1, 2018 are due to negotiations of the PHO Services Agreement Amendment (PSAAP) Protocol Group. This group negotiates the national agreement on the financing and provision of primary services and includes PHOs, contract providers (mainly general firms), DHBs and the Ministry of Health26. For example, the changes may lead to a net proportional shift of youth resources to older age groups,13 with equitable consequences for Maori and peaceful communities.