When the government announced the details of the changes to chronic disease management plans in May, many were sceptical that they would be an improvement for either doctors or patients.
But now that GPs have had a bit of time to try the new care plans out, what has their experience been?
Well, 44% say they are easier than the previous management plans and team care arrangements, while 36% say they are about the same, according to an August Healthed poll with nearly 1600 GP respondents.
Twelve percent have found them more difficult, and the remainder haven’t used them yet.
“There seems to be less onerous paperwork and fewer grey areas,” one GP commented.
Over one quarter of respondents (27%) say the changes to chronic condition management plans have translated to reduced workload for them – though most (59%) say it hasn’t affected their workload one way or the other, and a minority (14%) have noticed an increase in workload.
Some GPs who experienced increased workload cited the added burden and red tape of checking patient registration with MyMedicare.
Much of the early criticism of the new care plans involved concerns over remuneration – with AMA president Dr Danielle McMullen among those saying the pricing structure would constitute a cut for many GPs.
Several GPs in this month’s survey commented that the changes were translating to less income.
The “overall effect of reduced rebate will make it difficult for [our] clinic to meet costs,” one said, while another said the reduced subsidy meant less nurse time, which equated to more work for them.
However, Dr Chris Bollen a GP and director of Bollen Health who consults in chronic disease management has argued that the reduced rebate can be offset if GPs shift to doing quarterly reviews for patients with chronic conditions, rather than just writing a new plan each year.
“By changing our own and our patients’ habits, performing quarterly reviews will both increase your income and increase the quality of the care you provide,” Dr Bollen said.
Still, with the short lead time before changes came into effect, there is lingering uncertainty with some GPs saying they were confused about templates, session limits, review cycles, eligibility criteria, and transition processes.
Around 10% of respondents had not used the new items yet.
“My patients who would already need 44s for their issues now needing the care plan on top and expecting it to be bulk billed; adds bureaucratic work to my already rigorous management, to detriment of remuneration.”
“The cost paid by Medicare is not enough to do a full comprehensive care plan.”
“Easier but still very time consuming now for a much-reduced fee. I have to deliberately not put as much time into them as they aren’t cost effective if too much time spent on them.”
“Instead of bulk billing GPMP/TCA I now charge my usual gap.”
“Less pay for the same workload.”
“The newer plan management is rather confusing with little control of the GP in regard to the number of sessions for a particular allied health item.”
“Confusion about transition times between an old GPMP and a new GPMP. I mean what should be the gap? Is there a gap at all?”
“Mainly confused over what is now allowed and what is not. Patients don’t understand what they are allowed and neither do the health professionals.”
“Easier but harder as due to reduction in Medicare subsidy there is hardly any nurse time, and I have to do most of the work, and it is hard to fit it in with complex patients.”
“Having to start new template all over again takes time, but need for 3 provider requirement removal is appreciated.”
“Remuneration doesn’t reflect effort as the effort remains the same. Great not to have to call allied health providers etc for collaboration.”
“Removing the TCA process is good, but having to now write a referral is additional paperwork!”
RACGP | Summary of changes to CDM Framework (with webinar links)
RACGP | Changes to CDM Framework – FAQs
Department of Health, Disability and Ageing | Details of the changes
Services Australia | Steps to create and manage a GPCCMP
Read Dr Chris Bollen’s tips for making the new management plans work for your practice.
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