Model card v1.7.2: full parameterised primary care funding scaffold

Model name

Full parameterised scaffold for primary care funding architecture in Aotearoa New Zealand.

Version

v1.7.2. This version incorporates red-team and devil’s advocate findings into the model communication layer.

Intended use

• Compare the relative logic of funding architectures.
• Identify which assumptions are load-bearing.
• Support public explanation, policy discussion, stakeholder validation and OIA/data planning.
• Prepare the pathway for future empirical calibration.

Not intended for

• Claiming precise reductions in emergency department presentations, admissions or costs.
• Producing an implementation business case.
• Replacing stakeholder validation, equity review or linked-data analysis.
• Claiming that any organisation has endorsed the model.
• Arguing that fee-for-service alone is superior to capitation.

Core policy question

Does a hybrid architecture allow lower-cost upstream care to expand safely before need becomes hospital demand? In this model, hybrid means capitation for population responsibility plus an uncapped, scheduled, rules-based fee-for-service stream for eligible primary medical activity, with place-based accountability.

Strongest counter-hypothesis

The current reform pathway may be sufficient to improve access without a new uncapped scheduled fee-for-service stream. That pathway includes capitation reweighting, the access target, the National Primary Care Dataset, digital access, urgent-care investment, PHO accountability and separate appropriations.

What the model must not hide

• Uncapped activity without audit, item rules and place accountability is a high-risk scenario.
• Co-payments can worsen inequity unless protected.
• Scope expansion can fragment care unless tied to shared records, governance and continuity.
• Rural access may need capital, workforce, housing, salaried and infrastructure levers as well as item payments.
• Accident Compensation Corporation is an analogy for rules-based claims, not a complete model for illness-based primary care.

Inputs

The scaffold uses 70 parameters across demand, supply, funding, governance, ambulance, hospital, equity, risk and implementation domains. v1.7.1/v1.7.2 tiers these into core, extended and exploratory parameters.

Outputs

• Access and supply indices.
• Hospital pressure indices.
• Fiscal/gaming risk indices.
• Hybrid viability scores.
• Scenario comparison and sensitivity outputs.

Validation status

Parameterised scaffold only. Not empirically calibrated to linked New Zealand administrative data.

Interpretation rule

Use the model to ask better questions and prioritise validation. Do not use it to claim final effect sizes.