What you can do now to prepare for MyMedicare

As practice managers, we stand on the cusp of a transformative moment in the Australian healthcare landscape. The government’s commitment of $824.4 million towards digital health initiatives heralds the dawn of MyMedicare, an initiative designed to enhance the continuity of care in our healthcare system. Before analysing which patients to register, make sure you have set up your practice to take advantage of MyMedicare with the organisation register.

We are still waiting for further information on the implications of MyMedicare, but if it holds true to the Strengthening Medicare Taskforce Report, there could be drastic changes afoot.

Are you ready?

In this article, we’ll explore steps you can take now to help prepare for MyMedicare. Even though we’re awaiting much more information about the changes, engaging regular patients with chronic disease management is a great pursuit for patient outcomes and increasing billings for your practice.

Know Your Patients for MyMedicare

The first step to preparing for MyMedicare effectively is understanding your patient base. Regularly reviewing your Royal Australian College of General Practitioners (RACGP) active patients list is essential. According to the RACGP 5th edition standards for accreditation, standard C7.1, around the content of patient health records, it’s important to review the patient information. An active patient according to the RACGP standards is a patient who has had 3 or more visits with a practice in the last 24 months. We recommend generating a list of patients who meet that criteria, this gives you a great representation of your active patient base.

This review process offers an insightful snapshot of your patient population, their healthcare needs, and trends in care delivery.

Cubiko can facilitate this task by offering lists of patients with three or more visits, and you can compare that to your list of inactive or active patients from your practice management software. This data can inform you of frequent visitors to your practice. You can use this information to strategise your engagement with these patients under the new MyMedicare system.

Strengthen Patient-Practitioner Relationships

MyMedicare places a premium on the relationship between patients and healthcare providers. It rewards proactive and preventive care, encourages extended telehealth consultations, and incentivises GPs to register frequent hospital attendees.

To prepare, start by reinforcing the relationship between your patients and their GPs. This can be done by filling in the ‘usual doctor’ field in your Practice Management Software (PMS). This way, you can record and understand the relationship of each patient with their practitioner.

Cubiko provides a handy ‘patient preferred practitioner’ metric that can assist in managing these relationships. The patient-preferred practitioner metric uses data from your patient’s appointments and which GP they see to generate measures for a patient’s preference for particular GPs. Measuring patient preference to GPs at your practice allows you to look at measures that can strengthen the relationship between a GP and their patient base.

Engage patients in care with GP Management Plans

A GP Management Plan (GPMP) is a plan for patients to manage their chronic condition. A GPMP and Chronic Disease Management (CDM) is a great way to provide continuous patient care and be incentivised appropriately by Medicare for those services.

You can take steps now in your practice to provide GPMPs to your patients to help deliver outstanding care. In Cubiko, through Item Optimisation, practices can view upcoming patient appointments who may be eligible for a variety of MBS items. Cubiko crunches the data on patient eligibility through clinical indicators and the billing history of patients. Practices then can also use QuickCheck to verify the patient’s eligibility with Medicare and whether that item has been billed at another practice. This is especially important with GPMPs for new patients to the practice.

Without Cubiko, you can still generate lists of patients potentially eligible for GPMPs. You can look at clinical indicators or billing history. For example, look at how many Phase 1B COVID vaccines you delivered. The clinical indicators for a Phase 1B COVID vaccine could have a correlation to patients potentially eligible for a GPMP.

Champion 10997 & 10987s Across Your Practice

In the lead-up to MyMedicare, we suggest ensuring that the wider care team is involved with the health initiatives you’ve put in place. A great example of this is using 10997 and 10987 item numbers in your practice. These item numbers relate to review and coordination services for patients on GPMPs or TCAs, promoting continuity of care. It involves the wider care team by incorporating your nursing staff into your practice’s health initiatives. It is unclear at present if or how 10997s or nursing staff will be incorporated in MyMedicare, but let’s take the opportunity to use this item number for continuity of care across our patient base.

Why this is important in the lead-up to MyMedicare is because it allows a point of contact for your nursing team with a patient on a GPMP. Patients are eligible for 5 10997s or 10 10987s per calendar year when they are on a GPMP with your practice. Providing a 10997 to patients where clinically appropriate will enable continuity of care across your most at-risk patients. Providing these services, billed by the GP, allows remuneration for nursing time spent with patients.

Cubiko can help you here, too. Review your 10997 completion rate from last year and set new goals. Utilise Cubiko to identify potential patients and develop a nurse workflow to manage 10997s/10987s proactively. This will increase your Medicare billings and ensure your patients receive proactive care.

Proactive Care for Patient Health Assessments

Under MyMedicare, proactive care has become more important than ever. Health assessments for specific age groups, like those aged between 40-49 years for diabetes risk or 45 – 49 health assessments, are opportunities to provide proactive health care.

Typically, these patients don’t visit the practice frequently, but these checks are a great way to engage them in their care. Moreover, engaging with patients proactively and focusing on continuity of care fit into MyMedicare’s focus on preventive care and long-term management. We don’t specifically know yet whether health assessments or GPMPs for that matter will be included in the plans for MyMedicare. What we do know is that proactively engaging with patients in their care can lead to results where health complications are found early and as a result can help reduce the pressure on our hospital system.

The Cubiko platform can support you in identifying patients potentially eligible for these health assessments, providing insights into your patient population. With Cubiko, you can be more strategic in your care delivery, helping to ensure no patient falls through the cracks. You can use the insights found within Cubiko to proactively engage these patients with care under the MBS and where you deem clinically appropriate.

In conclusion, the healthcare landscape in Australia is changing, with tools like Cubiko playing a crucial role in supporting these transformations. The introduction of MyMedicare marks a significant shift towards strengthening the relationship between doctors and patients, incentivising continuity of care, and effectively managing chronic diseases. The initiative also aims to ease the load on emergency departments by encouraging GPs to register frequent hospital goers.

Though there are still many questions about the practicalities of its implementation, the potential benefits of MyMedicare are evident. Tools like Cubiko, with its advanced analytics and features such as ‘potential new CDM patients’, can potentially assist practices in navigating these changes.

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