One month into new chronic disease items – are they working?

It’s been a month since the Federal Government launched its highly debated chronic condition management (CCM) items but as the dust has settled, the RACGP says GPs are adapting to the major transition despite some ‘teething issues’.
 
The Federal Department of Health, Disability and Ageing (DoHDA) introduced new arrangements on 1 July, ceasing items for the preparation of GP management plans, team care arrangements and reviews and replacing them with a single GP chronic condition management plan.
 
Recommended by the MBS Review Taskforce, the revamp aimed to ‘simplify, streamline, and modernise’ the arrangements for healthcare professionals and patients, and to promote continuity of care.
 
However, tensions were high among GPs in the lead-up to the change.
 
Repeated calls for clarity from the RACGP eventually led to the new items’ start date being deferred.
 
Reflecting on the first month, the DoHDA said the introduction of the new CCM items ‘has gone smoothly’.
 
‘There has been strong support for several elements of the changes, particularly those that simplify and streamline the process for GPs and general practices,’ a spokesperson told newsGP.
 
This includes the removal of multiple plans, and the removed requirement for collaboration with members of the patient’s multidisciplinary team in the development of the plan, the DoHDA explained.
 
It also removed the need for a referral form for allied health services, instead allowing standard referral letters in the same way that a GP refers a patient to a non-GP specialist, to simplify the provision of relevant clinical information to allied health professionals.
 
RACGP President Dr Michael Wright said he has received early feedback on the new items suggesting many GPs are finding them easier to navigate than previous arrangements with less paperwork required, although some issues related to MyMedicare registration have been reported.
 
‘These chronic disease items are crucial to what we do in general practice – 61% of the population have chronic health conditions, and these item numbers are really important for the financial viability of practices,’ he told newsGP.
 
‘The good thing we’ve heard is that the logistics, or the paperwork side of it, is easier. You don’t have to do the team care arrangement, and you don’t have to do particular EPC referral forms, so that’s actually been really helpful.
 
‘I’ve been hearing from a lot of doctors who have found the logistics of completing the new one easier, which is great.’
 
The new plan is available to patients with at least one medical condition that has been, or is likely to be, present for at least six months, or is terminal.
 
Patients registered through MyMedicare are required to access the plan and review items through the practice where they are registered, while other patients can access the items through their usual GP.
 
Dr Wright said there have been some early teething issues around MyMedicare enrolment, resulting in some claims being rejected and practices being unsure as to why.
 
The DoHDA explained that if a patient is registered in MyMedicare they must receive the plan and review services from the practice at which they are registered.
 
‘If the patient is not registered, they can receive the services from their usual GP,’ the spokesperson said.
 
‘Practices can check a patient’s MyMedicare registration status through downloading a list of registered patients from HPOS, or through using the MBS Item Online Checker.’
 
Dr Wright said the RACGP will keep monitoring this, but at this early stage he is pleased to see the change has been received positively overall.
 
‘It’s an area that we are still monitoring and it’s about making sure people are registered with their regular GP and not registered with other practices. So, I think it is really important that patients understand the registration process,’ he said.
 
‘It’s important this registration process does not act as a barrier for patients accessing care from their usual GP or practice.’
 
The DoHDA also noted that there is no requirement for GPs to wait for a fixed period of time before transitioning a patient to the new arrangements.
 
‘While there is no minimum claiming period between the GP management plans and team care arrangements, and the new GPCCMPs, no immediate action is required unless it is clinically relevant,’ the spokesperson said.
 
‘Patients can continue to access allied health and other services under their existing plans until 30 June 2027.’
 
To help GPs make the switch to the new arrangements, the Department has published a suite of fact sheets to support the changes, and detailed explanatory notes on MBS Online to further support GPs, general practices and allied health providers.
 
The RACGP has been advised one of the most common causes for CCM rejection appears to be if an incorrect provider number is used. Many GPs have multiple provider numbers from different locations, and if this linkage is not accurate, claims are being rejected. 

Dr Wright has sought advice from the DoHDA about how to correct this, with the RACGP to add advice to its website when received.
 
He says he has been assured that if practices can check these linkages and correct them, they should be able to resubmit any claims which to date have been rejected.
 
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