The single tranche of information on the plan to merge GPMPs and TCAs ‘says a lot without saying anything meaningful’, says one practice owner.
With chronic disease management constituting 25-30% of some practice’s revenue, concerns over the lack of a dollar figure for the new GP chronic disease management plan MBS item is giving practice owners the heebie-jeebies.
Last May, the federal government announced plans to replace the current GP Management Plan and Team Care Arrangement MBS items with a single item number.
The implementation is scheduled to take effect from 1 November, but the government is yet to put a dollar figure on the new item.
The lack of clarity has prompted concerns over whether the changes will constitute a funding cut.
Speaking to The Medical Republic, practice owner and co-founder of Scale My Clinic Dr Sachin Patel said it was unsurprising that owners were worried.
“General practices are being told there’s going to be changes, but aren’t being told the details,” he said.
“There’s been one release of information that says a lot without saying anything meaningful.
“And so, of course, that’s a concern for practice owners.”
At a chronic disease management (CDM) workshop for practice owners run by Dr Patel today, a number of the meeting’s 300-plus attendees said 25-30% of their practice’s revenue came from CDM.
“My main message to a practice owner, or anyone who’s in a leading position in general practice, is I don’t think you can wait for the cavalry … It’s not going to happen,” Dr Patel told TMR.
“General practices are private businesses, and whether we like it or not, private businesses need to adapt to the environment.”
Dr Patel said it would be ill-advised to wait for the government, and the time was nigh to start having conversations with all team members to start future planning.
“There’s been countless examples of last-minute announcements over the years [regarding] funding for general practice,” he said.
“The reality is that this is just another example of that.
“[Care plans are] a fundamental piece of the work that general practice does, and the funding also supports or is required for quite a lot of the staffing in general practice.”
The looming changes will leave two groups: those that start making “smart changes” to keep their practices viable and those who “bury their head in the sand”, said Dr Patel.
“I don’t think we can afford to do that,” he said.
According to newsGP, RACGP president Dr Nicole Higgins penned a letter to the federal health minister Mark Butler outlining the “devastating impacts” on patient health of funding cuts to CDM and calling out the “lack of basic respect” for GPs.
“If adequate funding for these patient CDM cannot be confirmed in the coming days and weeks, we seek your intervention to delay the introduction of these changes until March 2025 to ensure there is sufficient time to plan ahead for our patients,” she wrote.
Dr Patel said the college was right to raise these concerns, but was unconvinced that they would get the answers they were looking for.
“I do wonder whether the government even actually knows themselves what the numbers are going to be,” he said.
“In reality, I suspect they’re still deciding … and maybe having arguments behind closed doors.
“It’s shocking.”
Dr Patel said there was a “strong possibility” that the changes might get put off but encouraged practices to use this time to future proof their businesses by proactively modelling and adapting for change.
“People can get focused on the funding, but they’re not actually thinking about the wider, strategic and tactical pieces of a successful chronic disease management program, and so it’s easy to fixate on the rebate and forget all the other work that does actually need to be done to make it run successfully,” he said.
CDMs, while a significant part of what general practice does, were not the be all and end all.
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Dr Patel said that with these changes looming, it was the perfect time to look at the “bigger picture” of a practices business model and sustainability.
“[This] is a change being foisted upon general practice by others, but we have the ability as business owners to be much more intentional about what we want to create and achieve and do for our communities,” he said.
Dr Patel said the CDM debacle was indicative of a repeated pattern seen with general practice funding from the government, and was reminiscent of the UK system.
“I’m originally from the UK,” he said.
“[Australia has] one of the world’s best primary health care systems, and yet we want to try and copy one of the worst, the NHS.
“Pretty appalling leadership by government, I’d say.”
