Medicare Management Plan
Helping You With Your Medicare Management Plan
In Australia, more people are living with chronic health conditions every year. Health care providers struggle to deal with the increased demand for their services, caused by the ongoing pressures of managing complex chronic health conditions.
Essential to the development of care for patients is ensuring access to coordinated and cost-effective services that are personalised to their needs. Medicare Management Plans are designed to help people with chronic medical conditions. It provides an organised approach to their care to improve the management and treatment of their chronic conditions.
What Is A Chronic Medical Condition?
A chronic medical condition has been or is expected to be, present for six months or more. While there is no complete ‘list’ of such conditions, Services Australia has found that below are the most widespread chronic conditions that Australians have to live with:
- Asthma
- Cancer
- Cardiovascular Disease
- Diabetes
- Kidney Disease
- Musculoskeletal Conditions (E.g., Arthritis, Osteoarthritis)
- Stroke
These medical conditions often need a structured approach where GPs can plan and coordinate the care of patients with complex conditions, requiring care from a multidisciplinary team. Your chosen GP can determine whether a medicare management plan is appropriate for you.
Useful Acronyms to Know
Here are among the most popular acronyms used when discussing Medicare Management Plans. There are two types of plans that can be prepared by a GP for Chronic Disease Management: GP Management Plans and Team Care Arrangements.
| General Practitioner | GP |
| Chronic Disease Management | CDM |
| GP Management Plans | GPMP |
| Team Care Arrangements | TCAs |
Patient Eligibility for Medicare Management Plans
To determine whether a patient is eligible to receive Chronic Disease Management (CDM) services, a GP will conduct a thorough, clinical assessment. This procedure considers a patient’s medical condition and care needs, in addition to general support.
Different Forms of Medicare Management Plans
GP Management Plans
If you suffer from a chronic, or terminal, health condition, your GP may propose a GPMP. In its most basic form, a GPMP is a plan of action you have agreed with your GP to organise a care and treatment plan for your chronic medical condition.
This plan seeks to
- Recognise Your Health Care Needs
- Outline the Services to Be Delivered by Your GP
- List the Actions You Can Take to Help Manage Your Chronic Condition
You must agree to the plan with your GP before any treatment or care can take place; this needs to be a written agreement.
Team Care Arrangements
Additionally, if you have more complex care requirements and need treatment from multiple health service providers, your GP may recommend TCAs to you.
The purpose of TCAs is to help synchronise the services you receive from your GP and other health care providers. This way, the management of your condition, and the treatment you receive will be aligned within your multidisciplinary team. Your chosen GP needs to collaborate with a minimum of two other health care providers who all provide continuing services to you.
When preparing and recording TCAs, this may involve
- Setting goals for the treatment and services for the patient
- Discussion of how each party of the multidisciplinary team will contribute to the TCAs and for which treatments and services
- Any actions the patient needs to take
- Review dates
List of Eligible Allied Health Providers
- Aboriginal Health Workers or Aboriginal and Torres Strait Islander Health Practitioners
- Audiologists
- Chiropractors
- Diabetes Educators
- Dietitians
- Exercise Physiologists
- Mental Health Workers
- Occupational Therapists
- Osteopaths
- Physiotherapists
- Podiatrists
- Psychologists
- Speech Pathologists
If applicable, Medicare covers the payment for the treatment or service. For more detailed information, please get in contact with your GP, Shire Doctors & Dentists.
Bringing Together GPMP and TCAs
GP management plans and team care arrangements help GPs coordinate the care of people living with chronic health conditions, while also helping to decrease the need for ad hoc sessions.
Therefore, it is possible to have a GPMP and TCAs simultaneously. If you have both plans, you may even be entitled to Medicare rebates for specific allied health services.
Your GP has the responsibility to determine whether you are eligible for these allied health services, which must be directly related to the management of your chronic condition. Our practice nurse at Shire Doctors & Dentists would provide support and monitoring between visits to your GP. You would have a copy of your management plan(s), and you and your GP would often review these plan(s).
Start Your Medicare Management Plan in The Shire Today
The introduction of GP Management Plans and Team Care Arrangements has aided many Australians in the management of chronic and complex health needs.
Medicare Management Plans aim to be adaptable, up-to-date, and need to be regularly reviewed by your GP. As an important facet of the plan, you and your GP need to verify that your goals are being met and decide on any necessary changes.
At Shire Doctors and Dentists, we are 100% dedicated to providing high-quality patient care, as well as effective treatment and management of chronic medical conditions. See your trusted GP to start discussing your Medicare Management Plan needs with the professionals at Shire Doctors and Dentists.
