In the 2019-20 Budget, the Government announced $448.5 million over three years to support voluntary patient enrolment for patients aged 70 years and over. In the 2019-20 Mid-Year Economic and Fiscal Outlook, the Government announced an additional $7.2 million to extend this to Aboriginal and Torres Strait Islander people aged 50 years and over.
Voluntary patient enrolment aims to build on the fee for service model and improve both patient and population health outcomes. This will occur by encouraging continuity of care in general practice that is flexible, proactive and preventive in nature.
GPs in Royal Australian College of General Practitioners (RACGP) accredited practices will be able to enrol their regular patients.
A ‘regular patient’ is defined as a patient who has seen the same GP three times in the previous two years.
To be eligible for enrolment a patient must be:
- Aged 70 years and over; or
- Indigenous and aged 50 years and over.
Implementation of VPE
From 1 July 2020, four new MBS items will be established:
- Mainstream enrolment item ($36) and mainstream quarterly item ($30) – for patients aged 70 years and over; and
- Indigenous enrolment item ($36) and Indigenous quarterly item ($30) – for Aboriginal and Torres Strait Islander patients aged 50 years and over
Once a patient has been enrolled (via claiming the enrolment MBS item) providers will be able to claim the quarterly MBS item. The ‘quarter’ refers to calendar quarters ie 1 January to 31 March, 1 April to 30 June, 1 July to 30 September and 1 October to 31 December. A provider will be able to claim the quarterly item for a patient that was enrolled at any point during the quarter (ie the patient does not need to have been enrolled for the full quarter). Claiming of the quarterly item will be done following completion of the quarter (ie from 1 October 2020 for the period 1 July to 30 September 2020).
Medicare will provide GPs with a list of their enrolled patients in Health Professional Online Services (HPOS) at the end of each quarter to support service delivery and MBS claiming. A new patient list will be produced and provided on the first day following the end of each quarter (ie 1 October, 1 January, 1 April and 1 July each year).
The list will:
- Be specific to a provider.
- Be able to be accessed by any authorised person for whom the provider has given HPOS access.
- Include all patients for whom the provider has claimed the enrolment item, and for which they are the most recent provider to claim the enrolment item for that patient (with the exception that in the quarter that a patient enrols with a new provider, that patient will appear on both the previous provider’s list and the new provider’s list, and both providers will be eligible to claim the quarterly item for that quarter only).
- Indicate to the provider if it is expected that a patient will not appear on their list next quarter.
Patient enrolment will be voluntary for both provider and patient.
A patient may choose to cancel enrolment or re-enrol with a different GP at any time (with the requirement to have seen that GP three times in the previous two years will remain).
Benefits for patients may include:
- Improved access – e.g. advice or follow up over the phone or by secure email;
- Convenience – e.g. repeat prescriptions or referrals where clinically appropriate without a face to face appointment; and
- Proactive care – e.g. recall systems to remind a patient when they are due for routine tests or immunisations.
Benefits for GPs include:
- Ability to formalise existing relationships with regular patients;
- Payment for non face-to-face services; and
- Increased ability to provide flexible and personalised care.
The Department of Health is working with Services Australia and stakeholder groups on the implementation detail of the measure. More information will be provided as details are finalised.