The unknowns vastly outweigh the knowns on this significant set of reforms.
Time is a-ticking on reforms to GP management plans and team care arrangements – but with just over two months left on the clock, the Department of Health and Aged Care is staying mum.
The changes, which will see multiple items rolled into a single GP chronic condition management plan, have technically been in the works since voluntary patient registration system MyMedicare was introduced in the 2023 budget.
They were originally scheduled to take place in November 2024 but were subsequently pushed back to July 2025.
With the government now in caretaker mode ahead of the May election, it’s unlikely that more details will be forthcoming within the next few weeks.
RACGP president Dr Michael Wright has written to DoHAC expressing concern that detail on the reforms has again been left too late.
Here are the knowns – and, more significantly, the unknowns – on the incoming changes.
Which items will be affected?
The official Department of Health and Aged Care webpage on the reforms does not reveal which item numbers specifically will be affected by the reforms.
It does, however, state that GP Management Plan and Team Care Arrangements will be replaced in line with recommendations from the MBS Review Taskforce.
A December 2020 report from the taskforce which looked at GP-related items went into more detail, specifically recommending that item 723 (Team Care Arrangements) and item 729 (GP Mental Health Treatment Plan) be deleted but item 731 (care plans prepared in a residential aged care facility) be left as is.
The same report also recommended changing the item descriptor, schedule fee and explanatory note for item 721 (GP Management Plans).
Related
Given that the government announced changes to bring mental health initiative Better Access under MyMedicare separately, it appears likely that the items primarily affected in July will be 723 and 721.
The DoHAC website also mentions that the rebates for management plan reviews will be equalised to encourage GP follow-up.
It follows that item 732, which covers care plan and team care arrangement reviews, may also be affected.
What will the new rebates be?
No rebates for the replacement item or items have been announced by DoHAC thus far.
Even the AMA and RACGP were reportedly kept in the dark on proposed rebates during negotiations with DoHAC last year.
The current rebate for items 723 and 721 are $130.25 and $164.35, respectively, while the rebate for a review under 732 is $82.10.
Billing a 723 and 732 would net a GP $212.35 in Medicare rebates per patient, while billing a 721 and 732 nets the GP $246.45 in Medicare rebates per patient.
Assuming the new items were rebated equally – i.e. writing the plan is rewarded the same as reviewing the plan – the new chronic care and plan review items would need to be worth between $106.18 and $123.25 each for GPs to receive the same sum of money per patient.
This does not factor in any potential block funding that may come from MyMedicare as part of the planned incentive payment targeted at people with chronic disease who attend hospital frequently, nor does it factor in bulk billing incentives.
It’s worth noting that more than 99% of chronic disease and complex care management items are bulk billed.
With politicians on both sides seemingly obsessed with variations to the national GP bulk billing rate, a move to cut rebates in this area appears unlikely.
Will patients have to register with MyMedicare to access chronic disease management?
DoHAC has been clear on the fact that patients who are not already registered with MyMedicare will be able to continue receiving management plans and reviews from whichever GP they so choose.
Patients who are registered with MyMedicare, though, will have to visit a GP at their registered practice.
Technically, these patients can move their MyMedicare registration to a different practice in specifically to access a chronic disease care plan and move it back to their regular GP at a later date; patients can move registrations as many times as they choose.
