Management Plans

This is a comprehensive document that sets out and enables evidence-based management of your chronic health and care needs. A chronic condition is deemed to be one that you have or will have, for more than 6 months. This plan is done once a year, with regular reviews (recommended six monthly) of your progress against the plan, and it is directly billed to Medicare. The most common chronic diseases are diabetes, asthma, emphysema, coronary heart disease, cancer of any type, osteoporosis and arthritis.

The plan involves you meeting with the practice nurse first, for about 30 mins, to discuss your medical condition/s and work with you to set goals and tasks to meet these goals. You will then see the doctor to complete the plan and look at what you have identified as to medical problems and goals.  The doctor will want to see you in 6 months time to review the goals and tasks and discuss any issues you have about the plan.

Team Care Arrangements

This item is for patients with a chronic or terminal medical condition and who might require ongoing care from a team approach, which involves the GP and at least two other health care providers, such as a specialist, physiotherapist, dietitian, chiropractor or podiatrist.

Once your usual GP (or a GP in the same practice) has coordinated the development of Team Care Arrangement by completing the relevant requirements, a rebate can be claimed through Medicare for Allied Health services.  Sometimes the allied health provider will direct bill Medicare for the treatment provided, so you have no out of pocket costs. (talk to the practice staff to  identify if your allied health person has out of pocket costs).

The service must include a personal attendance by the GP with you, but may be assisted by the practice nurse, Aboriginal Health Worker or other health professionals in the medical practice or health service.

Access to Allied Health

The following groups of allied health professionals are eligible to provide services under Medicare for patients with a chronic condition and complex care needs and must be registered with Medicare Australia. Some of these are; Aboriginal Health Workers; Audiologists; Chiropractors; Osteopaths; Podiatrists; Diabetes Educators; Dietitians; Exercise Physiologists; Mental Health Workers; Occupational Therapists; Physiotherapists; Psychologists; Speech Pathologists.

If you wish to seek Medicare rebates for allied health services, you will need to have a Referral form for chronic disease allied health (individual) services under Medicare signed by your GP. If there is any doubt about your eligibility, a staff member can contact Medicare Australia to confirm the number of allied health services already claimed by you during the calendar year.

Medicare benefits are available for up to five (5) allied health services per eligible patient, per the calendar year. These five allied health services can be made up of one type of service (eg five physiotherapy services) or a combination of different types of services (eg one dietitian and four podiatry services).

Mental Health Plans

he GP Mental Health Treatment Plans are for patients suffering from anxiety, stress or depression who would benefit from a structured approach to the management of their treatment needs. Many people suffer from stresses in their lives that significantly interfere with their thinking, behavior, socialisation, and emotions.

The treatment plan involves a discussion between your doctor and you regarding assessment, your needs, goals and actions, referrals and required treatment/services, and review date.   You or your doctor might suggest a referral to any of the following services; a psychiatrist; clinical psychologist, an appropriately trained GP or allied mental health professional for further management of your disorder.

Medicare benefits are available for up to twelve (12) mental health services per eligible patient, per the calendar year, to help with the cost of attending these health professionals.

40-49 Health Check

This health check is aimed at people aged between 40 and 49 years of age with a high risk of developing “Type 2 Diabetes”. All we ask you to do is obtain a Risk Assessment Form from your GP practice or online at www.diabetesaustralia.com.au

The Australian type 2 diabetes risk assessment tool (AUSDRISK) is a short list of questions to help both health professionals and consumers to assess the risk of developing type 2 diabetes over the next five years.

People with a high score result, > 12, are eligible to attend a Diabetes Risk Evaluation with their GP. If you meet the criteria of being at immediate or high risk, this is followed up with blood tests and a discussion about lifestyle changes.

45-49 Health Assessment

Do you have any of the following “risk factors” that may increase your chances of developing a chronic disease?

  • High Blood Pressure,
  • High Cholesterol,
  • Family History of diseases such as Diabetes, Cancer or Heart Disease,
  • Lack of Physical Activity,
  • Poor Diet
  • Smoker
  • Are you overweight?

If so, you might want to consider seeing your GP about a health check.

The purpose of this health check is to focus on the health needs of people around 45 to 49 years of age who are at risk of developing a chronic disease. The aim of the health check is to assist with the detection and prevention of chronic diseases and enable early intervention strategies to be put in place where appropriate.

75+ Health Assessment

This is a Health Check that should generally be undertaken by the patient’s usual doctor; that is the GP (or a GP working in the same practice) who has provided the majority of services to you in the past 12 months and/or who is likely to provide the majority of services for the following 12 months.

The assessment looks at the person’s health and physical, psychological and social function and whether preventative health care may be offered to that person, to improve their quality of life and independence in their home and in their community.

Sometimes a little help with home duties, going shopping or gardening is all that is needed; or maybe you need more assistance such as help with showering, medications, or wound care. These are tasks that you can access through community care groups that you might not be aware that are available.

It is through these health checks, that you and your GP can identify any needs or concerns you have regarding maintaining your independence at home.

Aboriginal & Torres Straight Islander Health Check

The health check is available each year, to all persons who identify as Aboriginal or Torres Strait Islander descent, regardless of age.

Indigenous people have a higher incidence of illness and higher mortality rate than other Australians, therefore regular health checks should help to reduce or prevent serious illness through early detection and treatment.

  • The purpose of this health check is to ensure all indigenous people receive the optimum level of health care
  • To encourage early detection and diagnosis of common and treatable diseases
  • To reduce the incidence of common and treatable diseases that cause considerable morbidity and early mortality

Access to Queensland Indigenous Health can be arranged for further management of health care if required.

Mental Health Plans

The GP Mental Health Treatment Plans are for patients suffering from anxiety, stress or depression who would benefit from a structured approach to the management of their treatment needs. Many people suffer from stresses in their lives that significantly interfere with their thinking, behavior, socialisation, and emotions.

The treatment plan involves a discussion between your doctor and you regarding assessment, your needs, goals and actions, referrals and required treatment/services, and review date.   You or your doctor might suggest a referral to any of the following services; a psychiatrist; clinical psychologist, an appropriately trained GP or allied mental health professional for further management of your disorder.

Medicare benefits are available for up to twelve (12) mental health services per eligible patient, per the calendar year, to help with the cost of attending these health professionals.

– See more at: Chronic Disease Management

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