MyMedicare

Adelaide PHN is pleased to support the introduction of MyMedicare, a voluntary patient registration system for general practice. We have been actively working with general practice in our region to improve their understanding and readiness for the MyMedicare launch.

MyMedicare

What is MyMedicare?

MyMedicare is a voluntary registration system designed to enhance healthcare delivery and patient experiences by allowing individuals to choose their preferred General or Nurse Practitioner and healthcare team. By registering with MyMedicare, patients and practices gain access to a variety of benefits, including:

Longer MBS-funded telephone calls
Triple bulk billing incentives for telehealth consultations
Tailored care for complex chronic diseases

Patients can register with a practice if they have had two (2) face to face visits recorded at the same practice in the past 24 months within the MM1 locations. One face to face visit recorded in the previous 24 months for patients registered with practices in MM6 and MM7 locations.

MyMedicare promotes stronger relationships between patients and their care teams, supporting person-centred care and reducing hospitalisations. It is integrated with My Health Record, facilitating effective communication and collaboration among healthcare providers. (updated July 2024)

Why Register with MyMedicare?

A well-supported general practice team can deliver sustainable, equitable, high-value healthcare that benefits both patients and providers.

Strengthens General Practice: Enhances the role of general practice in the Australian health system.
Integrated Communication: MyMedicare's integration with My Health Record allows easy communication between hospitals and a patient’s regular GP.
Better Patient Information: Practices will have improved information about which patients see them regularly, making it easier to tailor services to fit their needs.
Blended Funding Payments: Supports primary care providers in keeping registered patients with complex chronic diseases out of the hospital.
General Practice in Aged Care Incentive: Supports GPs in providing regular visits, health assessments, and care plans for residents in aged care homes.
Chronic Disease Management: From November 2024, items linked to a patient’s registration in MyMedicare will support continuity of care for people with chronic and complex conditions. Patients not registered in MyMedicare can still receive Chronic Disease Management items from their usual GP.

Improved Continuity of Care: Greater continuity of care with their registered practice, improving health outcomes.
Longer Telehealth Consultations: Longer MBS-funded telehealth consultations with their GP.
Triple Bulk Billing Incentive: For longer MBS telehealth consultations for children under 16, pensioners, and concession card holders, starting 1 November 2023.
Regular GP Visits for Aged Care Residents: More regular visits from their GP and better care planning for people living in residential aged care homes, starting August 2024.
Appropriate Care Connections: Better connections to appropriate care in general practice for frequent hospital visitors, starting mid-2024.

Who is Eligible?

For detailed information about MyMedicare eligibility for practices, General Practitioners, and patients, please visit the Department of Health and Aged Care website.

General Practice

Set up your practice as an Organisation in PRODA.
Link your Organisation to HPOS ORGREGM01 - Linking an Organisation in PRODA to HPOS (servicesaustralia.gov.au).
Record details in the Organisation Record ORGREGM02 - Creating an Organisation Record (servicesaustralia.gov.au).
Record details in the Organisation Site Record ORGREGM03 - Creating an Organisation Site Record (servicesaustralia.gov.au).
Link participating eligible provider and their provider numbers in the Organisation Register.

Patients

Patients have been eligible to register for MyMedicare since October 1, 2023, provided they have a valid Medicare card or DVA veteran’s card.
Registration can be completed through a GP-provided form, online via their Medicare Online account, or the Express Plus Medicare app.
Patients do not need to physically attend a practice to complete the registration.
If a resident cannot provide consent, a responsible person can do so on their behalf.

Directors or members with the Owner-Access attribute in Provider Digital Access (PRODA) will automatically have the MyMedicare attribute.
Other members must be assigned the HPOS-MyMedicare-Program-Staff attribute to access the MyMedicare program, which can only be added by a director or a member with Owner-Access.
Members also need the HPOS-Access attribute to access Health Professional Online Services (HPOS) on behalf of the organisation in PRODA.

Upcoming changes MBS: Chronic Disease Management Arrangements

The Department of Health and Aged Care has announced upcoming changes to the Medicare Benefits Schedule (MBS) for chronic disease management.

From Friday 1 November 2024, MBS items will be changing to.

Replace the current GP Management Plan and Team Care Arrangements with a single GP Chronic Condition Management Plan
Support continuity of care by requiring patients enrolled in MyMedicare to access management plans through the practice where they are enrolled. Patients who aren’t enrolled will be able to access management plans through their usual GP
Encourage management plan reviews by:
- equalising the fees for developing and reviewing plans
- requiring patients to have their plan established or reviewed in the last 18 months so they can retain access to allied health and other services
Formalise referral processes for allied health services so they are more consistent with other referral arrangements
Ensure patients do not lose access to their current services through transition arrangements for existing patients with GP Management Plans and Team Care Arrangements.

Current details about the changes to MBS chronic disease management arrangements are available on the Department of Health and Aged Care webpage with more information to be released in time.

What does it mean for providers?

The changes aim to simplify, streamline, and modernise the arrangements for health professionals.

Key changes include:

Removal of multiple plans
Collaboration with members of the patient’s multidisciplinary team will no longer be required in the development of the plan
Use of referral letters will support the provision of relevant clinical information to allied health professionals
Practice nurses, Aboriginal and Torres Strait Islander health practitioners and Aboriginal health workers can assist with the preparation and review of GP chronic condition management plans.

How can general practices prepare for the change?

Ahead of the changes, there are some practical steps you can take to ready your practice. Prior to 1 November, practices are encouraged

To register your practice for MyMedicare and link your participating providers to your Organisation Site Record (if you have not done so already) and,
register your patients with chronic conditions or existing care plans in MyMedicare

Further details can be found (attached and Upcoming changes to MBS Chronic Disease Management Arrangements | Australian Government Department of Health and Aged Care)

Key Dates

General practices can register for the MyMedicare program. To do this you must:

Make sure you’re eligible.
Link an organisation in Provider Digital Access (PRODA) to Health Professional Online Services (HPOS)
Access the Organisation Register in HPOS to register your practice and link your eligible providers.

For more information please visit the Service Australia Website.

Access to levels C and D telephone consultations for registered patients.
Access to triple bulk billing incentive for levels C, D and E (video only) telehealth consultations for registered patients under 16 years and Commonwealth concession card holders.
Removal of red tape for telehealth: no need to meet the 12-month rule for registered patients.
Visit MBS Online for more information.

From 1 August 2024, GPs and practices registered in MyMedicare will receive incentives for providing their registered patients who permanently live in a residential aged care home (RACH) with proactive face-to-face visits, regular planned reviews, and coordinated care planning, improving continuity of care and reducing avoidable hospitalisations.

For more information on this incentive, please click here.

Chronic Disease Management items linked to a patient’s registration in MyMedicare from November 2024, to support continuity of care for people with chronic and complex conditions.

Patients who are not registered in MyMedicare will still be able to receive Chronic Disease Management items from their usual GP.

For more information visit the Department of Health and Aged Care Website

Further registration benefits for patients are expected to be added as part of Strengthening Medicare. Adelaide PHN will continue to update and maintain information on this page.

For more information visit the Department of Health and Aged Care Website

General Practice Aged Care Incentive (GPACI)

Starting 1 August 2024, General Practitioners (GPs) and practices registered with MyMedicare will receive incentives for providing proactive face-to-face visits, regular planned reviews, and coordinated care planning for patients in residential aged care homes (RACH).

New Resources:

Key details include:

Proactive Care: Incentives for face-to-face visits and regular reviews to improve continuity of care and reduce hospitalisations.
Registration Requirement: RACH residents must be registered in MyMedicare, and GPs must be linked to the patient’s registered practice.
Incentive Structure: A combined service incentive payment (SIP) and practice incentive payment (PIP), with payments of $300 per patient, per year to the responsible provider, and $130 per patient, per year to the practice.
No Cap: The current cap of $10,000 per GP will be removed.
Rural loadings - Rural loadings will apply to provider and practice incentive payments for Modified Monash Model (MMM) regions MMM 3 – 7

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

Please note: The Practice Incentive Program - General Practitioner Aged Care Access Incentive (PIP GP ACAI) will cease on 31 July 2024. The final PIP GP ACAI payment will be made in August 2024 for the reference period 1 May to 31 July 2024. For more information click here.

For more details on the New General Practice in Aged Care Incentive, please refer to the Department of Health and Aged Care new fact sheet and web page.

We encourage you to take advantage of these opportunities to enhance the care you provide and support your practice. If you have any questions or need further information, Adelaide PHN will continue to provide information regarding these incentives, please do not hesitate to contact our Primary Support Team via Practicesupport@adelaidephn.com.au

Short video series

The following short (2 – 5 minute) video series produced by Southeast Melbourne PHN featuring Dr Billy Stoupas quickly explains MyMedicare and the General Practice in Aged Care Incentive from the perspective of a GP.