Chronic Disease Management

Chronic disease management is a rapidly growing area in Australia and in general practice.

The main vehicle to provide chronic disease care is what is know as care plans or GP Chronic Condition Management Plans (GPCCMPs) which evolved from the pre-existing GP Management Plans (GPMP) and Team Care Arrangements (TCA)

These items, when used correctly, have the potential to drastically improve the care and quality of life of patients with chronic conditions.

These plans also attract much higher Medicare rebates, even when bulk billed, which is why many practices have become increasingly more engaged in performing these services, which help the practice be more financially viable.

What are GP Chronic Condition Management Plans (GPCCMPs)?

GP Chronic Condition Management Plans provide funding for General Practice to create a plan to manage the care of a patient with a chronic condition.

Chronic Disease Management in General Practice

A GPCCMP should include:

• A discussion with the patient around their health needs or any current health problems
• Setting health goals or targets for treatment
• Outlining what services will be provided by the practice or by other external provider
• Outlining the responsibilities or 'actions' the patient agrees to take to help reach their health goals
• Listing and making relevant referrals to additional providers involved in the patient's care for their chronic condition
• Setting a date of review to get together again and track changes or progress towards their goals

The Medicare and 'audit' requirements around these items can be complex. We've put together a set of training courses to help demystify them and to allow you to easily navigate your way around them.

Navigating Chronic Disease Medicare items: MBS online

Information on individual Chronic Disease Management Medicare items can be found via MBS Online.

Random audits are carried out on a regular basis to make sure providers are claiming items correctly and following all item requirements before billing.

Getting clarification around Medicare requirements

If you have questions about a Medicare item and it's not clear from the explanatory notes what you would need to do to fulfil its requirements, you can contact Medicare either via phone using the Medicare Provider line 132 150 or by sending an email to askmbs@humanservices.gov.au

It can take a couple of weeks to receive a reply via email, but this is a more official and binding interpretation, whereas over the phone you will often get different 'interpretations' by different Medicare staff, which may or may not be defendable if you were to incorrectly claim an item.

Key Resources

• MBS Online