It's becoming less and less viable for GPs to bulk bill DVA card holders, the RACGP says.
The Department of Veterans’ Affairs is trying to work out what’s standing in the way of coordinated veterans’ care (CVC) program uptake.
It’s possible that the answer is less about the design of the program itself, and everything to do with the fact that participating in the CVC requires billing specific DVA card numbers.
What the program needs, according to RACGP feedback, is to be “funded through bundled care payments that adequately cover the cost of care being provided”.
The pool of GP practices that can afford to bill DVA fees – which are typically 115% of the MBS rates and must be bulk billed – has been steadily drying up over the last 18 months.
The CVC program itself allows DVA gold card holders with chronic health conditions and DVA white card holders with a DVA-accepted chronic mental illness to work with a GP and practice nurse to develop a comprehensive care plan with ongoing care coordination.
To be eligible, participants must be at risk of unplanned hospitalisation and be living in the community.
Plans are reassessed every 90 days.
A GP working with a practice nurse can bill $474.05 for an initial assessment and $494.70 for every reassessment, making the yearly rebate $2452.85 per patient for the first year.
The rebate for a GP without a practice nurse is less, at $296.30 for initial assessment and $222.30 per reassessment.
While broadly supportive of the CVC program, which it said “systematises complex care”, the RACGP told independent auditors that practices were increasingly choosing not to accept DVA cards.
“Unless indexation of the DVA fee schedule is increased, refusal of Veteran Cards will continue to limit the uptake of the CVC program,” it said.
The college also recommended simplifying the administrative requirements of the program, particularly the 90-day reassessments, which “add considerable workload to the patient’s care regimen and are not an intuitive part of the GP’s care plan”.
The bureaucratic process of navigating DVA requirements was also discouraging veterans from signing up for the program, the college added.
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Another recommendation to increase uptake was expanding the program to cover all white card holders aged over 50 with any type of chronic condition, rather than just mental illness.
“These changes will increase access for veterans, and mean GPs can catch chronic disease earlier, and help patients get on top of it, for better health outcomes,” RACGP president Dr Nicole Higgins said.
“GPs are expert in managing chronic conditions, and the earlier patients come to us, the better their health will be in the long run, which also means less pressure on hospitals and the health system.”
