Key budget announcements for GPs

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1 November 2023

• $3.5 billion investment over 5 years.
• Applies to:
  • all Medicare Benefits Schedule (MBS) Level B, C, D, E face to face attendances, including in and out of consulting rooms, in residential aged care facilities, in business and after hours
  • Level B telehealth (video and telephone)
  • Level C and D video and telephone and Level E video consultations for patients who register with a practice under MyMedicare.
• The new level C and level D telephone items, which will only be available for patients who are registered with a practice under MyMedicare, will replicate the requirements for current Level C (more than 20 minutes) and D (more than 40 minutes) GP general attendances. 
• Patients who are not registered with MyMedicare can still access level C, D and E video consultations, and current (single) bulk billing incentives will apply to eligible patients who are bulk billed.
• The only telehealth items that are restricted to patients registered in MyMedicare will be the new level C and D telephone.
• Based on current rates that would be (at 85%):
  • $20.65 for MM1
  • $30.15 for MM2
  • $31.95 for MM3 & 4
  • $34.05 for MM5
  • $35.85 for MM6
  • $39.65 for MM7

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1 November 2023

• $98.2 million for a new Level E consultation item for consultations at least 1 hour in length. The item descriptor will be finalised in consultation with the profession in coming months but as we understand it the item will be to support holistic care for the patient, particularly those with complex and/or multiple health care needs. This will include support for mental health issues. However, we are advised, that the service provided cannot be limited to mental health only.
• The rebated for an in-rooms Level E consultation during business hours is expected to be in the order of $190 (subject to indexation post 1 July and 1 November)

1 November 2023

• $5.9 million over 5 years for Level C and D telephone consultations for MyMedicare enrolled patients.

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1 November 2023

• The MBS descriptor will be amended to include a 6 minute minimum time for a Level B consultation, as recommended by the MBS Review Taskforce.

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1 July 2023

• General practices will be able to enrol to be part of MyMedicare via PRODA, HPOS and the Organisation Register.
• Practices must be accredited or working towards accreditation against the RACGP Standards for General Practice or the National Safety and Quality Primary and Community Healthcare Standards, or be eligible for a temporary exemption (details to be finalised).
• Ahead of patient enrolments, practices wanting to participate in MyMedicare are encouraged to register on the Organisation Register. GPs who don't have a PRODA account but intend to participate will need will need to register for one. 

1 October 2023

• Patients will be able to enrol with a participating general practice, with the option to nominate a preferred GP at the practice.
• Patients can register either in practice or via the Medicare app.
• Practices on the Organisation Register, via HPOS, can link to MyMedicare (by selecting the MyMedicare tile).
• MyMedicare will be integrated with practice software over time to further streamline the registration process.
• There is no payment for enrolling a patient to MyMedicare but it unlocks the ability to provide longer MBS funded telephone consultations, access to additional funding streams for providing care to RACF patients and patients who frequently attend hospitals, and ensures that enrolled patients access chronic disease management through the practice they are enrolled with.
• Patient education on MyMedicare will be provided by the Department of Health and Aged Care.

1 November 2023

• The government is moving to a new indexation formula for its programs including the Medicare schedule. This formula will take into greater account movements in labour costs, a key component of practice costs.
• There will be a one off additional indexation round on 1 November, which is expected to be 0.5% on top of the expected 3.6% indexation increase on 1 July.
• Going forward, indexation of the MBS is likely to be higher under the revised formula than has previously been the case.

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1 August 2024

• $98.9 million over 4 years from 2023–24 to connect frequent hospital users to a general practice for comprehensive care to reduce the likelihood of hospital re-admission.
• This will commence in 9 Primary Health Network (PHN) areas and, scale up over three years to all 31 PHN areas.
• The proposal is based on existing and successful models such as the one in Brisbane Metro North Health, where PHNs and Local Hospital Networks work together to identify suitable patients.
• Further consultation will be undertaken to co-design the program, with some indicative funding figures having been provided by the Department of Health and Aged Care in response to early questions. While these are obviously subject to final program design, per eligible patient payments are as follows:
  • 1st  year $2000
  • 2nd year $1,500
  • 3rd year $1,000
  • $500 bonus for keeping people out of hospital

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Immediate

Funding for the Practice Incentive Program continues while an overall review of PIP is undertaken over the coming year.

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1 November 2024

• An implementation Liaison Group will be formed to settle a new Chronic Disease Management (CDM) item structure and related requirements.
• Advice to the AMA is that the government wants the CDM item structure to be streamlined to reduce administrative burden, with a rebalancing of rebates so that there will be a single MBS CDM item as the entry point (including for referral to allied health) with a higher fee attached to CDM reviews than is the case now.
• Access to CDM items for MyMedicare enrolled patients will be restricted to their nominated general practice.
• Non enrolled patients will still be able to access CDM items.

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1 May 2025

• $47.8 million over 5 years from 2022–23 (and $12.3 million per year ongoing).
• This is intended to provide access to subsidised wound consumables for eligible patients with diabetes and a chronic wound.
• The initial target group will be people with diabetes aged 65 and over, and First Nations people 55 and over.
• While the detail is to be determined, the initial thinking from government is that a participating GP will request wound consumables for the patient from a Chronic Wound Consumables schedule, which are then delivered to the patient to bring with them into the practice for application.
• This measure includes education and training for health care professionals on chronic wound management, with these programs to be made available prior to the implementation date.

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1 August 2024

• $112 million over four years from 2023-2024 to introduce a new General Practice in Aged Care incentive payment for services provided to patients in Residential Aged Care Facilities (RACFs).
• Funding for PIP Aged Care Access Initiative (ACAI) will be extended for one year until 1 August 2024.
• Initial advice indicates that the existing ACAI will eventually be discontinued with the ACAI funding re-invested into this new program.
• Under the new funding arrangements it is anticipated that a GP will receive a $300 per patient SIP annually (paid quarterly) over and above any MBS billings if they deliver a defined mix of services to enrolled patients (which includes a monthly visit).
• Similarly, $130 per patient will go to the practice via the PIP.
• Rural loadings based on Modified Monash Model will apply to these payments.
• There is the potential for some flexibility in the program to cater for other team member’s attendance and for providers that do not have general practice accreditation but deliver GP services to RACF residents.
• The usual RACF MBS fee for service items plus the triple bulk billing incentive remain available.
• Some funding will be allocated for PHNs to commission services in areas where GPs are not generally accessible.

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1 July 2023

• $445.1 million over 5 years from 2022-2023.
• The maximum funding cap lifted to $130,000 per practice.
• Unlike previous years, the WIP will be indexed each year.
• Small and medium practices will receive a 30% increase to their incentive payments (subject to the operation of the maximum funding cap).
• The benefit to larger practices will be limited, essentially only receiving the benefit of the increased cap.
• A streamlining of the eligibility tiers will see more general practices eligible for the maximum payment.
• The linkage of the Standardised Whole Patient Equivalent (SWPE) to the maximum incentive amount has been decreased from 5000 to 4000.
• The rural loadings will continue to apply.