Guide to a Successful CVC Program: Enhancing Patient Care

As a practice manager or nurse, you have a crucial role in delivering quality healthcare to patients, particularly those with complex healthcare needs. One way to enhance patient care is by implementing a successful Coordinated Veterans’ Care (CVC) Program. This article will provide valuable information on the CVC Program, including its objectives, eligibility criteria, and tips on finding potential patients. Moreover, we will discuss the importance of employing nurses and measuring the return on investment (ROI) for your CVC program.

What does CVC stand for?

CVC stands for Coordinated Veterans’ Care, a program initiated by the Australian Department of Veterans’ Affairs (DVA) to provide better, coordinated care for eligible veterans with chronic conditions or complex care needs. This initiative acknowledges the unique sacrifices and experiences of veterans and aims to address their specific healthcare requirements in a more tailored manner.

The CVC Program focuses on a team-based approach to healthcare, where general practitioners, practice nurses, and other healthcare providers collaborate to deliver a comprehensive and coordinated care plan for each eligible patient. By fostering better communication and cooperation among healthcare professionals, the program aims to create a more seamless patient journey, ensuring that veterans receive the necessary care and support to manage their chronic conditions effectively.

Moreover, the CVC Program also emphasises the importance of preventive care and early intervention. By providing timely and appropriate care to veterans with chronic health conditions, the program aims to minimise the risk of complications and prevent the need for hospitalisation. This proactive approach not only helps improve the quality of life for veterans but also reduces the strain on the healthcare system.

In summary, the CVC Program is an essential initiative designed to support veterans with chronic conditions or complex care needs, addressing their unique healthcare requirements through a coordinated, team-based approach. By emphasising preventive care, early intervention, and collaboration among healthcare providers, the program seeks to enhance the overall well-being and quality of life for eligible veterans while also reducing the burden on the healthcare system.

What is the CVC Program?

The CVC Program is designed to assist general practitioners (GPs) in providing proactive, coordinated care to eligible DVA Gold Card holders. The program emphasises a team-based approach to care, involving GPs, practice nurses, and other healthcare providers in the management and coordination of the patient’s healthcare. The ultimate goal is to improve the patient’s health outcomes, prevent hospital admissions, and enhance the overall patient experience.

How are patient eligible for the CVC Program?

Patients are eligible for the CVC program if they meet the following criteria:

  1. Hold a DVA Gold Card or a DVA White Card
  2. One or more chronic conditions or complex care needs requiring ongoing clinical care for Gold Card holders. For White Card holders, the patient may be eligible if they have a DVA-accepted mental health condition.
  3. Be at risk of hospitalisation due to these chronic conditions or complex care needs.

The program primarily focuses on veterans but caters to war widows, widowers, and dependants under specific circumstances.

The CVC Program can be billed under the Medicare Benefits Schedule (MBS) through specific item numbers, which are as follows:

  1. GP with practice nurse:
    1. CVC Program initial assessment and program enrolment (UP01)
    2. CVC Program review, can be completed every 90 days (UP03)
  2. GP without practice nurse:
    1. CVC Program initiation and program enrolment (UP02)
    2. CVC Program review, can be completed every 90 days (UP04)
CVC program mbs items

The above table can be found on the DVA website for further information on claiming. Please always refer to government information when claiming.

There are some instances where a patient may not be eligible for the CVC Program due to several reasons, this includes:


  • Not being a DVA Gold Card holder: The CVC Program is designed specifically for eligible DVA Gold Card holders. Patients without a Gold Card will not be eligible for the program.
  • Absence of chronic conditions or complex care needs: The program targets veterans with one or more chronic conditions or complex care needs that require ongoing clinical care. If a patient does not have such conditions or care needs, they will not qualify for the program.
  • Low risk of hospitalisation: The CVC Program aims to prevent hospital admissions for eligible patients. If a patient is not at risk of hospitalisation due to their chronic conditions or complex care needs, they may not be eligible for the program.

It is crucial to assess each patient’s eligibility based on these criteria before enrolling them in the CVC Program to ensure that the program’s resources are directed towards those who need it the most.

Employing Nurses and Measuring ROI for Your CVC Program​

Employing nurses to participate in the CVC Program is essential, as they play a vital role in coordinating care, managing patient health, and implementing individualised care plans. Furthermore, they often serve as the primary point of contact for patients and their families, facilitating communication and support throughout the care journey. APNA has some great resources that can help a medical practice facilitate nurses in their CVC program.

To measure the return on investment (ROI) for your CVC Program, consider the following key performance indicators (KPIs):

  1. Improved health outcomes for patients: Track patients’ progress in the program, including improvements in the management of chronic conditions, a reduction in hospital admissions, and overall well-being.
  2. Enhanced patient satisfaction: Assess the level of satisfaction among patients and their families, which can be measured through surveys, feedback, and testimonials.
  3. Increase in billings: Run a report on the CVC Program item numbers to see how many you bill and compare that to the cost of a nurse’s wages over that time.
  4. Team performance and collaboration: Evaluate the effectiveness of team collaboration, communication, and care coordination, which can lead to better patient care and improved health outcomes. You may measure this with a team meeting after you’ve launched the program at your medical practice.
Don’t forget! If you are looking to drive the CVC Program at your practice and make an improvement for patient care, you can champion that as a Quality Improvement Program.
Nurses are a great source of patient care for your practice. Consider the item number 10997 for nurses that provide care relating to a GPMP, or a patient’s chronic condition. As always, the GP must still bill the item number under medicare. 

Finding Potential Patients Eligible for the CVC Program

To identify potential patients eligible for the CVC Program, consider the following strategies:

  1. Review patient records: Evaluate the medical history of your current patients to identify those with chronic conditions or complex care needs, and cross-reference with DVA Gold Card status.
  2. Consult with GPs: Discuss the CVC Program with GPs to identify eligible patients and encourage referrals to the program.
  3. Collaborate with local DVA offices: Develop a relationship with your local DVA office to facilitate referrals and share information about the CVC Program.
  4. Leverage patient networks: Encourage existing CVC Program patients to share their experiences with fellow veterans who may also benefit from the program.
  5. Utilise marketing and outreach: Promote the CVC Program through your practice’s website, social media, and other marketing channels to reach potential patients.
  6. Use Cubiko: If you already have Cubiko, you can find potentially eligible patients from your patient database through our CVC eligibility lists.
The CVC Program is a great example of how your practice can provide outstanding patient care while being financially sustainable. 

Bringing it all together

Implementing a successful CVC Program in your practice can significantly improve patient care and health outcomes for eligible veterans with chronic conditions or complex care needs. By understanding the objectives and eligibility criteria of the CVC Program, employing dedicated nurses, and measuring your program’s ROI, you can ensure that your practice is delivering optimal care to those who need it most.

Additionally, proactively identifying potential patients eligible for the CVC Program, through strategies such as reviewing patient records and collaborating with GPs and local DVA offices, can help expand the reach of your program and provide much-needed support to the veteran community.

By following the steps outlined in this article, you will be well on your way to enhancing patient care and making a positive impact on the lives of veterans and their families. Remember, a well-coordinated and patient-focused CVC Program not only benefits the patients themselves but also contributes to the overall success and reputation of your practice.

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