Government provides MyMedicare incentive clarity

The Commonwealth has broken down the details of a new incentive designed to more fairly remunerate GPs supporting patients in aged care, with the launch just weeks away.
 
The new MyMedicare General Practice in Aged Care Incentive will start on 1 August, with a goal of creating better continuity of care, reducing avoidable hospitalisations, and facilitating regular visits.
 
However, the launch comes amid previous criticism of the incentive, with GPs describing it as too low and its requirements as too onerous.
 
Under the new initiative, GPs must provide eight consultations and two care plans to a residential aged care patient every year to be eligible for a $300 payment.
 
Additionally, telehealth can only be used in Modified Monash Model (MMM) areas 4–7 for up to four regular visits per year.
 
Of the eight consultations, only one each quarter can be delivered by a member of the patient’s care team other than the usual GP.
 
Practices and providers can register themselves and deliver eligible services from 1 July, with the first incentive assessment period continuing until September.
 
The incentive payments will be quarterly and in addition to existing Medicare Benefits Scheme (MBS) and Department of Veterans’ Affairs (DVA) rebates.
 
The Federal Government has confirmed providers can benefit from rural loadings and rebates from longer and more complex MBS items included in the incentive servicing requirements.
 
Providers may also be eligible to receive the triple bulk billing incentive for each bulk-billed visit to an aged care resident.
 
Despite describing the incentive as ‘underwhelming’, RACGP President Dr Nicole Higgins is nonetheless encouraging practices to sign up.
 
‘It costs GP significant money and time away from their patients to visit aged care facilities and all of the work that’s generated around their patients in aged care, so this is a start but I see this as a down payment,’ she told newsGP.
 
‘GPs have always done aged care but because this has been undervalued and underfunded, we’ve seen GPs leave aged care.
 
‘There’s always been a social contract between GPs and their patients, but when that social contract has been devalued and defunded in the past, it has led to GPs leaving aged care when we need doctors to continue to provide continuity for their patients.’
 
The incentive comes in the wake of the damning Royal Commission into Aged Care Quality and Safety, which called for sweeping changes to the sector.
 
In a recent newsGP poll, asking which public health issue will most significantly impact general practice in Australia in the next 10–20 years, 23% of voters pointed to Australia’s ageing population.
 
However, according to an earlier newsGP poll, 54% of respondents said they would not provide the MyMedicare aged care services, regardless of the incentive.
 
Dr Higgins said GPs play a vital role in helping their elderly patients as they leave their homes and move into an aged care facility, but this work must be supported and appropriately funded.
 
‘As patients get older and sicker, we need to fund general practice and primary care to keep people in their homes in the first place, and then support their transition into aged care facilities,’ she said.
 
‘There needs to be better recognition of the value general practice brings into this space and their knowledge of whole person complex care and support, as well as increased support for multidisciplinary care teams located in general practices.
 
‘General practice is running on thin margins and GPs have subsidised aged care visits for a long time. We simply cannot afford to continue to do that and this incentive goes only part way in helping.’
 
With the introduction of the new service, the existing Practice Incentives Program GP Aged Care Access Incentive (PIP GP ACAI) will end on 31 July and final payments will be made in August for the reference period 1 May to 31 July.
 
GPs have three payment quarters from the date the old incentive ends to finalise outstanding payments, and after this time, any outstanding payments are forfeited and will not be paid. 
 
However, the Commonwealth confirmed practices and providers may be eligible to receive payments under both the PIP GP ACAI and the new incentive for services delivered while both programs are active if criteria is met.
 
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aged care MBS Medicare Medicare Benefits Schedule MyMedicare residential aged care