‘Extremely concerned’: Frustration boils over amid CDM uncertainty

Despite multiple attempts to seek clarification on how changes to chronic disease management (CDM) MBS items will be funded in the future, GPs say they remain in the dark.
 
And now, in a new letter to Federal Health and Aged Care Minister Mark Butler, the RACGP said he must delay the move until it is able to provide all the details, saying GPs are ‘extremely concerned’.
 
The plan to change the MBS items on 1 November was announced in last year’s May Budget, which will replace the current GP Management Plan and Team Care Arrangements with a single GP Chronic Condition Management Plan.
 
But more than a year down the track, and with just 46 days until its introduction, the Federal Government has still not informed GPs exactly how they will be able to bill their patients.
 
Concerns were raised over the funding structure in August, with RACGP President Dr Nicole Higgins calling on the Federal Government to urgently explain its plans.
 
Now, Dr Higgins has amped up the pressure once again, warning Minister Butler of the ‘devastating impacts for patient health’ if CDM funding is cut.
 
‘We are extremely concerned the proposed changes are set to be introduced in less than three months and government have not yet confirmed rebates for these CDM items,’ she wrote in the letter.
 
‘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 said the inaction has already drawn the ire of GPs across the country.
 
‘GPs are angry and it’s very disrespectful that we haven’t been told what the item number is,’ Dr Higgins told newsGP.
 
‘We’ve heard why it’s changing, we’ve heard what’s changing, but there’s no dollar amount attached.’
 
A recent newsGP poll laid bare just how much the changes stand to impact patients, asking GPs whether they would have to start charging a fee for Medicare items 721 and 732, rather than bulk billing patients, if chronic disease funding is not increased.
 
Alarmingly, 69% of the 1367 respondents said they would have to start charging a fee.
 
As a practice owner, Dr Higgins says she has already had to delay major decisions due to the uncertainty.
 
‘We can’t plan our business, we’re holding off on employment as we await the funding announcement,’ she said.
 
‘We deserve better than this, our patients deserve better.’
 
Data from the National Health Survey shows that one in two Australians live with a chronic condition, with 99.2% of chronic disease and complex care management items bulk billed by GPs.
 
For Dr Higgins, these patients account for up to 20% of those visiting her practice – and its these vulnerable patients she fears will now have to cover costs.
 
‘My concern is that we will have a large group of patients who need the most support, who potentially will be out of pocket and disadvantaged because of the inertia of the Government around chronic disease payments,’ she said.
 
Also detailed in Dr Higgins’ letter is the RACGP’s ‘disappointment at the misrepresentation of the RACGP’s role in the development of these reforms’.
 
‘Our representation in the Implementation Liaison Group did not allow for any formal feedback on the funding amounts attached to these items and the overall lack of information provided to this group has been a critical concern of the RACGP from day one,’ she said.
 
With the CDM changes scheduled for just over six weeks away, Dr Higgins says time is running out for the Government – who she says must either front up with the facts or push the plan back.
 
‘At a time when we’re trying to build trust and there is so much reform happening, the lack of basic respect is not helpful,’ she said.
 
‘Time is of the essence.’
 
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bulk billing chronic conditions chronic disease care chronic disease management plan general practice funding MBS MBS items Medicare