General Practice in Aged Care Incentive

The General Practice in Aged Care Incentive supports older people living in residential aged care. This will help them receive quality primary care services from their regular provider and practice.

About the incentive

The General Practice in Aged Care Incentive promotes continuous, quality care. Developed in response to the:

From 1 July 2024, eligible providers and practices registered with MyMedicare will be able to receive incentive payments. These incentive payments are for providing regular visits and care planning to older people living in aged care.

Why it is important

Older people living in Residential Aged Care Homes (RACHs) will receive regular visits and care planning services from their responsible provider and practice. This will improve continuity of care and reduce avoidable hospitalisations. 

Incentive payments

Each quarter, providers and practices registered with MyMedicare, meeting the General Practice in Aged Care Incentive eligibility and servicing requirements, will receive an incentive payment. 

Eligible providers will receive payments for reviewing their patients in a Residential Aged Care Home, rather than at their practice. 

Eligible practices will receive funding to manage the care for registered patients living in a Residential Aged Care Home.

Payments are: 

  • $300 per patient, per year, paid to the responsible provider, and
  • $130 per patient, per year, paid to the practice.

The payments will be quarterly, in addition to existing Medicare Benefits Scheme (MBS) and Department of Veterans’ Affairs (DVA) rebates for services delivered.

Rural loadings will apply to provider and practice incentive payments for Modified Monash Model (MMM) regions MMM 3 to MMM 7. 

Payment eligibility

Providers and practices must meet both eligibility and servicing requirements to be eligible for incentive payments, in any assessment period (quarter). 

Incentive payments will be:

  • assessed
  • calculated
  • paid according to processes outlined in the Program Guidelines and Services Australia processes. 

Eligibility to participate

Practice eligibility   

General practices must be an eligible practice and registered in the:

  • Organisation Register
  • MyMedicare program (with banking details added)
  • General Practice in Aged Care Incentive program.

Practices will be able to register for the General Practice in Aged Care Incentive through the MyMedicare program from 1 July 2024. 

Provider eligibility   

Providers must be: 

  • an eligible provider
  • linked to their eligible practice   
  • declared as the responsible provider of eligible services to the registered patient, including coordinating services provided by the care team. 

Providers will be able to participate in the General Practice in Aged Care Incentive from 1 July 2024. 

Patient eligibility 

Patients must: 

  • permanently live in a Residential Aged Care Home, not including respite care 
  • register with the MyMedicare program and link to an eligible practice and responsible provider 
  • have the General Practice in Aged Care Incentive indicator selected on their MyMedicare profile by their practice. 

Patients can be registered by their practice for the General Practice in Aged Care Incentive from 1 July 2024. Patients can contact their provider and/or practice if they would like to be a part of the program.

It is the responsibility of providers and practices to ensure a patient is eligible for MyMedicare. The provider and/or practice must declare their patient meets the eligibility criteria for General Practice in Aged Care Incentive as part of the patient registration process. Practices will need to:

  • link providers and their MyMedicare patients to their practice 
  • select the General Practice in Aged Care Incentive indicator on their patients’ MyMedicare profiles
  • link patients to responsible providers in their practice. 

Servicing requirements 

Eligible providers and practices are required to meet the servicing requirements to be eligible for incentive payments, including delivering:

  • Two eligible care planning services over a 12-month period; and  
  • Two eligible regular visits per quarter, each in a separate calendar month, delivering at least eight regular services in a 12-month period. 

Eligible services include a range of MBS and DVA items as outlined in the Program Guidelines. 

Quarterly visits

Services must be delivered under the responsibility and direction of the responsible provider.

Providers and practices will be required to meet: 

  • all servicing requirements outlined in the Program Guidelines
  • individual servicing requirements for each assessment quarter to be eligible for payment.

At least one of the regular visits must be provided by the responsible provider.

A second visit can be delivered by the responsible provider or another member of the patient’s care team. This includes:

  • an alternate provider within the same practice
  • GP registrar
  • nurse practitioner
  • Aboriginal and Torres Strait Islander health practitioner or health worker.  

Modified Monash Model areas MMM 4 to MMM 7

Practices will be able to provide four regular visits per 12-month period of eligible telehealth MBS items if registered patients are unable to attend a face-to-face service.

Resources

Date last updated:

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