Indigenous Health PIP Incentives for general practice - May 2010
This page describes practical steps for general practices seeking to make use of the indigneous health incentive for general practice.
From May 1 2010, the Australian Goverment introduced additional incentives for general practices to assist Aboriginal people maintain their health.
This page includes the following:
- What's in it for the practice?
- What's in it for the patient?
- Where to start - a brief guide for general practice
- Optimising practice benefits
- What do do before the appointment
- What to do during the appointment
What’s in it for the practice?
1. Sign on payment - $1000 per practice. A one-off payment.
2. Patient registration payment - $250 per eligible patient per year.
3. Outcomes Payment – up to $250
Tier 1 - $100 per eligible patient per year. Paid to practices for each registered patient for whom a target level of care is provided by the practice in a calendar year.
Tier 2 – An additional $150 per eligible patient per calendar year. Paid to practices providing the majority of care for a registered patient in calendar year.
4. ATSI Health Check - $196.65 no more than one every 9 months.
A 30-40min appointment to register the patient and conduct an ATSI health check will generate $446.65 for the practice. In comparison two to four Level B consultations will only generate between $68.60 to $137.20.
A proactive practice can make $500 a year per patient registered for the ATSI health incentive PLUS $196.65 for the ATSI health check and any additional income generated from item numbers billed throughout the year.
What’s in it for the patient?
1. Better management of their chronic disease and overall health.
2. After ATSI health Check Item 715 - Access to 5 allied health services per calendar year and 10 follow-up services with practice nurse on behalf of the GP.
3. If patient also has a GPMP & TCA – another 5 allied health services per calendar year.
4. Cheaper medicines – concessional price (under $6) or free if patient has a concession card.
Where to start? - a brief guide for general practice
1. Fill in PIP Indigenous Health Incentive application form and send to Medicare.
2.Agree to seek consent to register all ‘usual’ ATSI patients with a chronic disease aged 15 and over for the Indigenous Health Incentive and /or PBS Co-payment.
3. Establish a recall & reminder system for all ATSI patients with a chronic disease.
4. Conduct or at least offer an ATSI Health Check – Item 715.
5. Make sure the practice is providing the majority of care for the patient by actively recalling them:
a. The patient can see the practice nurse up to 10 times in a calendar year.
b. Have an ATSI health check every 9 months.
c. See the GP as often as needed to manage their chronic disease.
6. Two staff from the practice to attend cultural awareness training within 12 months. BGPD running one this August (exact date TBC).
7. Annotate PBS prescriptions for ATSI patients participating in the PBS Co-payment from 1st July, 2010 with the letters CTG (Closing the Gap).
Optimising practice benefits
You can start by identifying all ATSI patients using the national standard identifying question “Are you of Aboriginal or Torres Strait Islander origin?
Current Patients
When a current patient comes in for an appointment get all reception staff to ask them the question “Are you of Aboriginal or Torres Strait Islander origin?’ irrespective of appearance, country of birth or whether the staff know of the client or their family background, and record the answer in the patient’s file. If reception staff are concerned about doing this tell them it is an accreditation requirement they record this information.
New Patients
When collecting a new patients contact details, DOB, Medicare card number etc reception staff also need to ask ‘Are you of Aboriginal or Torres Strait Islander origin?’ and record this in the patients file.
What do do before the appointment
Let the GP know the patient has identified as ATSI before the appointment. The GP can discuss the indigenous health incentive with the patient and make another appointment to register them and conduct the health check. A patient is more likely to come in for the health check if they know they will be registered to get cheaper medicines and more allied health services at the same time.
If the practice has already been recording this information, get the practice manager to run a search in the practice software for all ATSI patients.
Get one of the GP’s to review this list and any ATSI patient aged 15 years and over, with a chronic disease or is at risk of developing one, should be phoned and booked in for an appointment. Inform the patient it is so they can be registered for the Indigenous Health Incentive and to have a health check so their medical condition can be better managed and so they can get all their medications at the concessional price.
What do do during the appointment:
a. Get patient to fill in and sign consent form - keep in patient’s file.
b. GP to fill in and sign registration form – fax to Medicare to get $250 payment for that year.
c. Give patient a copy of the ‘Closing the Gap’ PIP patient information sheet.
d. Conduct an ATSI health check – item 715 - $196.65.
e. Enter a recall in software or book an appointment for patient to see GP or practice nurse in a few months time depending on their medical condition.
f. Also enter a recall in software to get patient back in 12 months to conduct another ATSI health check and to re-register them.
This one appointment will generate $446.65 for the practice.
1. The $250 registration payment will be paid to the practice that registers the patient first. Practices can phone the PIP team on 1800 222 032 to find out if an eligible patient is currently registered with another practice.
2. The health Incentive registration only lasts for a year. Patients need to be called in annually to complete a new registration form and for practice to get the $250 payment. Don’t risk losing your ATSI patient to another practice in a year’s time. Proactively manage their health care during the year and register them annually.
3. The PBS Co-payment registration only has to be done once.
"Closing the Gap" PIP patient information sheet
http://www.hrdgp.org.au/client_images/907507.pdf
Contact Bankstown GP Division
What’s in it for the practice?
1. Sign on payment - $1000 per practice. A one-off payment.
2. Patient registration payment - $250 per eligible patient per year.
3. Outcomes Payment – up to $250
Tier 1 - $100 per eligible patient per year. Paid to practices for each registered patient for whom a target level of care is provided by the practice in a calendar year.
Tier 2 – An additional $150 per eligible patient per calendar year. Paid to practices providing the majority of care for a registered patient in calendar year.
4. ATSI Health Check - $196.65 no more than one every 9 months.
A 30-40min appointment to register the patient and conduct an ATSI health check will generate $446.65 for the practice. In comparison two to four Level B consultations will only generate between $68.60 to $137.20.
A proactive practice can make $500 a year per patient registered for the ATSI health incentive PLUS $196.65 for the ATSI health check and any additional income generated from item numbers billed throughout the year.
What’s in it for the patient?
1. Better management of their chronic disease and overall health.
2. After ATSI health Check Item 715 - Access to 5 allied health services per calendar year and 10 follow-up services with practice nurse on behalf of the GP.
3. If patient also has a GPMP & TCA – another 5 allied health services per calendar year.
4. Cheaper medicines – concessional price (under $6) or free if patient has a concession card.
The Basics
1. Fill in PIP Indigenous Health Incentive application form and send to Medicare.
2. Agree to seek consent to register all ‘usual’ ATSI patients with a chronic disease aged 15 and over for the Indigenous Health Incentive and /or PBS Co-payment.
3. Establish a recall & reminder system for all ATSI patients with a chronic disease.
4. Conduct or at least offer an ATSI Health Check – Item 715.
5. Make sure the practice is providing the majority of care for the patient by actively recalling them:
a) The patient can see the practice nurse up to 10 times in a calendar year.
b) Have an ATSI health check every 9 months.
c) See the GP as often as needed to manage their chronic disease.
6. Two staff from the practice to attend cultural awareness training within 12 months. BGPD running one this August (exact date TBC).
7. Annotate PBS prescriptions for ATSI patients participating in the PBS Co-payment from 1st July, 2010 with the letters CTG (Closing the Gap).
How to Really Make the Most of it
- Start identifying all ATSI patients using the national standard identifying question “Are you of Aboriginal or Torres Strait Islander origin?
a) Current Patients - When a current patient comes in for an appointment get all reception staff to ask them the question “Are you of Aboriginal or Torres Strait Islander origin?’ irrespective of appearance, country of birth or whether the staff know of the client or their family background, and record the answer in the patient’s file. If reception staff are concerned about doing this tell them it is an accreditation requirement they record this information.
b) New Patients – When collecting a new patients contact details, DOB, Medicare card number etc reception staff also need to ask ‘Are you of Aboriginal or Torres Strait Islander origin?’ and record this in the patients file.
c) Let GP know the patient has identified as ATSI before the appointment. The GP can discuss the indigenous health incentive with the patient and make another appointment to register them and conduct the health check. A patient is more likely to come in for the health check if they know they will be registered to get cheaper medicines and more allied health services at the same time.
- If practice has already been recording this information, get the practice manager to run a search in the practice software for all ATSI patients. Get one of the GP’s to review this list and any ATSI patient aged 15 years and over, with a chronic disease or is at risk of developing one, should be phoned and booked in for an appointment. Inform the patient it is so they can be registered for the Indigenous Health Incentive and to have a health check so their medical condition can be better managed and so they can get all their medications at the concessional price or free.
- During the appointment:
a) Get patient to fill in and sign consent form - keep in patient’s file.
b) GP to fill in and sign registration form – fax to Medicare to get $250 payment for that year.
c) Give patient a copy of ‘Closing the Gap’ information sheet.
d) Conduct an ATSI health check – item 715 - $196.65.
e) Enter a recall in software or book an appointment for patient to see GP or practice nurse in a few months time depending on their medical condition.
f) Also enter a recall in software to get patient back in 12 months to conduct another ATSI health check and to re-register them.
This one appointment will generate $446.65 for the practice.
- The $250 registration payment will be paid to the practice that registers the patient first. Practices can phone the PIP team on 1800 222 032 to find out if an eligible patient is currently registered with another practice.
- The health Incentive registration only lasts for a year. Patients need to be called in annually to complete a new registration form and for practice to get the $250 payment. Don’t risk losing your ATSI patient to another practice in a year’s time. Proactively manage their health care during the year and register them annually.
- The PBS Co-payment registration only has to be done once.
More information
Contact Bankstown GP Division