Enhanced Primary Care
Contact
Anna Wood
Program Coordinator
Email Anna Wood
Tel. 9416 7689
On this page
Overview of Enhanced Primary Care
Health Assessments
Care Plans
Dental
Home Medicines Review and Care Planning
Case Conferences
Download Enhanced Primary Care resources
Links to new resources and more information
Overview of Enhanced Primary Care MBS items
The Enhanced Primary Care Program is a Commonwealth initiative to provide Medical Benefit Scheme (MBS) items to General Practitioners to enhance their patient care.
The MBS items includes three broad categories: Health Assessments, Care Plans and Case Conferencing. GPs can initiate or participate in the provision of these items, depending on whether the patient is in the community, in residential care or in the acute sector.
More recently, the EPC items are increasing being utilised in mental health, diabetes, asthma and cardiovascular disease, and as part of the HARP projects and Coordinated Care Trials.
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Health Assessments
MBS Items 700, 702, 704 & 706
These items have not changed.
For patients over 75 years of age or Indigenous Australians over 55 years.
Health Assessments are conducted once a year (excludes patients in hospital, nursing home or special accommodation).
Includes assessment of:
- Medical
- Physical
- Psychological health
- Social function
Health assessments can be performed at the clinic or at home.
Health Assessment Proforma
MBS Items 718 & 719
Improving the annual health review for people with an intellectual disability.
The Comprehensive Health Assessment Program (CHAP) is now a part of the annual health review for people living in department managed disability residential services. Support staff will complete the first part of the CHAP form, which provides general information about the person’s health issues, and give it to the medical practitioner. This will ensure information about a person’s medical history is available at consultations. The second part of the CHAP form provides prompts for specific areas that should be considered by practitioners in the annual health review. The final section of CHAP prompts support staff and the GP to work together to develop a plan of action. CHAP satisfies the requirements of the Medicare rebate for items 718 and 719.
Two new Medicare Benefits Schedule items provide a GP with a rebate of $199 for a comprehensive health assessment (item 718) and $222 where this assessment involves a home visit (item 719), to ensure that the GP has sufficient time to conduct a thorough health assessment for people with an intellectual disability.
Click here to download the letter provided to each GP by DHS employed support staff when supporting a resident to attend an appointment - Department of Human Services, Disability Services Division – Residential Services Information for medical and health professionals.
Click here to go to the Health Check and Assessments page.
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Care Plans
MBS Items 721, 723, 725, 727, 729 and 731.
(These items replace Items 720, 722, 724, 726, 728 & 730)
The new MBS items offer great potential for GPs in managing the care of people with chronic disease.
GPs now have the choice of:
| 1. An individual care plan, which is called a General Practitioner Management Plan (GPMP): MBS item 721. This is for patients of any age with a chronic or terminal medical condition. It should be prepared by the patient’s usual GP. This GP-only care plan does not require input from other health service providers. |
| 2. Team care planning, which is called a Team Care Assessment (TCA): MBS item 723. This is for patients of any age with a chronic or terminal condition and complex care needs, who also require on-going care from a multidisciplinary team of three health or care providers (including the GP). This should be prepared by the patient’s usual GP. |
A practice nurse or other health professional in the GP’s practice can assist in both the preparation of a GPMP and the TCA.
Allied Health and Dental MBS items are available to patients who have BOTH a GPMP (item 721) and a TCA (item 723) in place. Residents of aged care homes whose GP has contributed to a care plan prepared by the home will still have access to the allied health and dental care items.
GPs can claim both the diabetes annual cycle of care SIP, and a GPMP (item 721) for a patient. However the GPMP Review item (725) CANNOT be claimed in addition to the SIP.
GPs will have to choose between using either the GPMP, OR the Asthma SIP for patients. It will NOT be possible to claim both these items for the same patient.
Similarly, GPs will have to choose between using either the GPMP, OR the Mental health SIP for patients. It will NOT be possible to claim both these items for the same patient.
The new CDM items are available to all GPs (not just GPs in accredited practices.)
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Dental
Discontinuation of Medicare Dental Items for People with Chronic Conditions and Complex Care Needs (Items 85011-87777)
Medicare dental items for people with chronic conditions and complex care needs, introduced by the previous Government in November 2007, are to be withdrawn from the Medicare Benefits Schedule (MBS). This affects referrals by GPs, and services by dentists, dental specialists and dental prosthetists.
A new Commonwealth Dental Health Program will be introduced from 1 July 2008. The Government is replacing the previous Government’s limited chronic care dental scheme with a scheme that works cooperatively with States to address public dental waiting lists and provides up to one million additional services.The Government will negotiate with the States and Territories to provide priority services to patients with chronic disease, allowing patients who previously qualified for the closing chronic care dental items to access treatment where they are eligible for publicly funded care.
For more information contact Medicare Australia on 132 150 (GPs) or 132 011 (patients).
Click here to download an information sheet on frequently asked questions about the changes.
(AGPN update – 6 March 2008 )
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Home Medicines Review and Care Planning
The Care Plan can identify the need for a Home Medicines Review.
The pharmacist can be counted as one of the members of the EPC care planning team only if the pharmacist works with the GP in developing the care plan, contributes to the plan, and provides ongoing care to the patient (more than routine pharmacy services).
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Case Conferences
MBS Items
| 740 |
742 |
744 |
746 |
749 |
757 |
| 759 |
762 |
765 |
768 |
771 |
773 |
These items have not been changed.
A Case Conference involves a detailed discussion regarding the patient's total management with at least two other allied health workers.
A conference must take place between the carers either face-to-face, on the telephone, video link or a combination of these.
The conference can be organised by the GP and other health workers. Rebates are time based and dependent upon whether the GP activates the conference or a health worker does. The patient is not required to have more than five conferences a year.
A Case Conference will include:
- Provision of relevant patient history
- Identification of problems
- Identification of management issues
- Setting (or review) of goals
- Evaluation of progress
- Management strategy
- Allocation of tasks to team members
Case Conference Proforma
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Enhanced Primary Care Resources
The Division has developed these resources for GPs to use in their practices.
Click on the title to download a copy:
EPC Summary Sheet - This is a two-page summary of the EPC MBS Items, the scheduled fees and the utilisation of those items.
Print it as a double-sided page to sit on your desk for quick and easy reference.
Eligible members of multidisciplinary care team - This lists all the people who can be included in a multidisciplinary care plan or case conference. Double check with this list if you are unsure of the criteria.
Patient Letter re Health Assessments - This letter can be sent to your patients to inform them that health assessments are available at your practice, and the purpose of an annual health assessment. Download this letter, insert your details and let your patients know what is going on.
2005 EPC Chronic Disease Management Templates
North East Valley Division has excellent templates with clear and simple instructions.
They are easily downloadable into Medical Director.
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Other links
RACGP
Look under "My practice" for forms and guidelines for Enhanced Primary Care
Commonwealth Department of Health and Ageing
Full details of Enhanced Primary Care items
Chronic disease management items - Commonwealth Department of Health
Go to Chronic Disease Management
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