Funding boost to add 120,000 GP services in RACFS

Anastasia Tsirtsakis

1/07/2021 4:37:00 PM

New Federal Government funding aims to increase face-to-face contact time between patients in residential aged care and their GP.

A GP with an elderly patient.
Increased investment into GP services is expected to strengthen the health and well-being of older Australians.

As of 1 July, GPs offering aged care services will be entitled to receive a maximum yearly payment of $10,000 through the introduction of additional qualifying service levels and incentive payments.
The $42.8 million funding is part of the Federal Government’s response to the Royal Commission into Aged Care Quality and Safety. It is designed to help support the health of the 244,000 Australians living in residential aged care facilities (RACFs) by increasing face-to-face contact with their GP.
‘This funding boost provides an additional 120,000 GP services to senior Australians living in aged care facilities,’ Federal Minister for Health and Aged Care Greg Hunt said. ‘[T]his is essential in ensuring senior Australians are treated with respect, care and dignity.’
Changes are currently underway to support the introduction of the additional payment tiers under the Practice Incentives Program (PIP) GP Aged Care Access Incentive (ACAI).
Capped at $10,000, GPs will receive service incentive payments based on the number of eligible items they deliver to patients in a financial year, based on the following criteria:

  • Tier 1a – 60–99 services for $2000
  • Tier 1b – 100–139 services for $2500
  • Tier 2a – 140–179 services for $2500
  • Tier 2b – 180+ services for $3000
The payments are accumulative. This means if a GP delivers 100 Medicare Benefits Schedule (MBS) services to patients in RACFs in 2021–22, they will receive a total payment of $4500, comprised of $2000 for delivering 60 services under tier 1a, and $2500 for delivering 100 services classed as tier 1b.
Effective for services provided by GPs from 1 July 2021, first payments are expected in the November 2021 quarter.
Chair of RACGP Specific Interests Aged Care Dr Khayyam Altaf welcomed the investment for both GPs and patients.
‘I’m pleased that there’s been recognition for all of the hard work that GPs do in this area, all of the extra work. They go well beyond, I would say, the call of duty,’ he told newsGP.
‘Regarding residents of aged care, I think it’s good for them. They’re going to have, hopefully, better access and it’s going to encourage good GPs to provide more services.’
There are no changes to eligibility for ACAI payments. As previously, GPs must:
  • be registered in the PIP at an approved practice
  • use a Medicare provider number linked to a PIP practice when claiming MBS services in RACFs
  • provide eligible MBS services to residents in RACFs
  • reach the Qualifying Service Level by providing the required number of MBS services in RACFs in a financial year.
However, Dr Altaf is concerned that a number of GPs working in age care will miss out on the remuneration, as a result of their practices not meeting the RACGP’s definition of general practice for accreditation.
‘GPs who are working solely, maybe on their own and they’re not attached to a traditional general practice, or some of the newer general practice services, which are catering just for aged care facilities, just don’t have a pathway to get accredited and, therefore, they can’t actually get this additional payment,’ he said.
‘So there’s going to be a lot of GPs that will miss out on these benefits.’
The RACGP’s definition of general practice sets out exactly who can be accredited against the Standards for general practice, and directly tied to Services Australia’s PIP. It was last updated in 2013.
However, in recognition of the changing landscape of primary healthcare and innovative models of care, the college released a consultation paper earlier this year, seeking member and stakeholder feedback on whether its definition reflects cotemporary general practice.
The consultation, which closed on 1 April, has led to a review that is currently underway and a report has been tabled for the next RACGP Expert Committee – Standards for General Practices (REC–SGP) meeting on 15 July, at which time the committee will discuss the outcomes of the consultation and qualitative data received.
Once the REC–SGP has decided whether the definition of a general practice for the purpose of accreditation will be updated, the RACGP Board will be asked to endorse the decision.
If the RACGP does update its definition, further consultation with members and stakeholders will occur, focusing on a new draft definition.
As it stands, Dr Altaf is among the GPs not eligible for the new funding.  Working for a mobile practice dedicated to delivering aged care services, they cater to more than 50 RACFs with a patient base in excess of 1000.
‘We provide a really good service and aged care facilities are pulling our arms to take on more patients, but there’s only so much we can do,’ he said.
‘One of the difficulties we’re having is recruiting more GPs because it’s just not seen as an attractive part of general practice.
‘So I think if the Government, or even the RACGP, can somehow look to incorporate these doctors, that would be a definite step forward.’
When it comes to future investment into aged care, Dr Altaf says past experience has proven it is vital for the Government to be liaising closely with both the RACGP and GPs themselves to find out exactly what is needed to improve the specialty.
‘GPs are essential in providing top-quality care to the elderly population, and given that the population will get older, more people will need aged care facilities or a GP that can look after them in their elderly years,’ he said.
‘It’s absolutely crucial now that the Government look towards supporting GPs to ensure that we’re involved.’
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Dr Michael Lucas Bailey   2/07/2021 7:07:00 AM

Most GPs aren’t entitled to a share of PIPs that s practice receives. A boost in funding for general practice - yes. A boost in profit for practice owners - yes. Motivation or benefit for GPs - No.

A funding arrangement designed with no understanding of what is to be funded.

Dr Diana Lorraine Hart, OAM   2/07/2021 7:11:55 AM

For years I have recognised the problem of GPS doing aged care independently of their day to day accredited practice and not being eligible for this incentive payment. I tried to get the AMA to take this up with government as I sit on one of their GP committees. It fell on deaf ears. It should be a SIP payment not a PIP payment as the accredited corporate practices that many of us work in want a huge percentage of what is earns doing the hard yards in providing aged care in order to access this payment and financially it has not been worth it. Hence many GPS that work a lot in aged care miss out. This is because the provider number they use for aged care is not linked to an ‘accredited practice’ claiming PIP. If the increase in funding had been used to increase the item number values this may have made aged care more attractive but as it stands it mainly lines the pockets of administrators not the doctors providing the service

A.Prof Christopher David Hogan   2/07/2021 10:23:07 AM

The sooner our politicians realise that paying for health services is an investment in the nation rather than a liability, the better off our people will be.
Those of us who started work in aged care more than 20 years ago have seen
* the progressive defunding of aged care,
* the progressive limitation of eligibility for payment for GPs,
* harassment of GPs for "overservicing" in aged care,
* the reduction of the number of Medicare items, reduction of eligibility for teleconsults
* the growth of unfunded paperwork (the abomination of "scripts owing")
* the growth of shadow funding like this PIP payment for which few GPs actually doing the work will actually receive!

Dr Nichola Lea O'Reilly   4/07/2021 5:50:20 PM

As a long term provider of consults to the RACFs, I renegotiated my employment contract to now take 100% of service fees and PIP-ACAI payments. I then pay a yearly service fee to the practice that more than adequately compensates him for the administration services. One of us is very happy with the arrangement and the other gets to keep his accreditation.