The new, voluntary system is meant to lock patients to a practice, but still makes it easy to change providers.
In theory, patient registration will stop opportunistic operators from billing expensive chronic disease plans to patients they don’t intend to see again – “theory” being the operative word.
Depending on who you listen to, MyMedicare is either the beginning of a slide into NHS-style capitation or the only hope for general practice’s continued viability.
Unfortunately, the scheme’s current offerings do not live up to the fearsome rhetoric of either side.
The only patient-facing incentive to sign up with MyMedicare is access to MBS rebates for long telehealth items.
More are expected to be announced in the future.
There are slightly more enticing drawcards for GPs: from July, clinics with enrolled patients in aged care will be able to access payments from the General Practice in Aged Care Incentive, which has taken the place of the aged care Practice Incentive Payment.
In order to earn the maximum $430 per patient per year, GPs will have to provide two care planning services over a 12-month period and two regular visits per quarter in separate calendar months.
From November, patients enrolled with MyMedicare will be required to see their registered clinician for chronic disease management.
This will likely be linked to a new blended funding payment targeted at people with complex chronic disease who attend hospital frequently, which will roll out over several years.
People who are not enrolled in the scheme can still see whichever GP they choose for chronic disease management.
A similar set of rules will apply to Better Access referrals from late 2025.
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Speaking at a session on MyMedicare at the RACGP Practice Owner’s Conference on Sunday, Dr Michael Wright speculated on the scheme’s inauspicious beginnings.
“I think the introduction has been quite slow to try and avoid opportunistic behaviour [from practices],” the RACGP funding and reform chair said.
“But as we get closer to November, I think that will create a stronger incentive for us to enrol our patients to stop that from happening.”
Delegates were encouraged to start registering chronic disease and aged care patients now so that the bulk were ready to go by their respective start dates in July and November.
Registered patients will still be able to see other GPs with no issue, but other GPs won’t be able to write their care plans.
Unless, of course, the patient shifts their registration – which they are free to do an unlimited number of times.
It’s unclear how the system will work to prevent a patient’s registration being arbitrarily shuffled around. The only block is that this would be mildly inconvenient for the patient and would not allow them any direct benefit.
“My understanding is that [MyMedicare] is designed to put more money into general practice through the funding stream for us to do the things that we just don’t get paid for,” Dr Wright said.
“Things like collaborating with our patients or encouraging us to do prevention on patients once we know they’re our patients.”
Dr Walid Jammal, a staple GP representative on government health reform panels, told delegates at another session that there had never been a more crucial time to formalise the GP-patient relationship.
“What funding do you need to service the requirements of the healthy adult population?” he said.
“What do they want … just ask InstantScripts, who now claim to have serviced one million of your patients.”
According to Dr Jammal, the best way for practices to retain patients into the future is to know who their cohort are and what types of care they need or value – something that can be made quantitative by patient registration.
He also believed the incoming MyMedicare aged care incentive would encourage quality over quantity.
“[Under the PIP] you could have one patient in a nursing home, see them three times a week for no reason whatsoever and hit the [minimum service level threshold],” Dr Jammal said.
“That’s not the purpose of aged care.”
The RACGP’s 2024 Practice Owner’s Conference was held at the Cairns Convention Centre on 25-26 May.
