Care planning-what you need to know to effectively manage chronic disease
Do you have a chronic condition? you may be eligible for a care plan.
Lifestyle related chronic diseases such as Type II diabetes, cardiovascular disease and chronic obstructive pulmonary disease (COPD) are pressing issues for our local communities and are leading to increased hospitalisations in the district. The Central Coast region has some of the highest rates of COPD and circulatory system disease in Australia.
Central Coast dwellers with a chronic medical condition may be eligible to receive Medicare benefits to cover medical and allied health services that help manage their condition.
The Chronic Disease Management (CDM) is one of the GP services on the Medicare Benefits Schedule (MBS) and enable GPs to plan and coordinate the health care of patients with chronic (or terminal) medical conditions, as patients with these conditions generally require multidisciplinary, team-based care from a GP and at least two other health providers.
Chronic Disease Management in General Practice involves appropriate prevention, early identification and best practice management strategies. General practitioners and their staff are usually the first point of contact in the health system and play a key role in the primary intervention, prevention, diagnosis and management of chronic disease in the community.
What is a chronic medical condition?
A chronic medical condition is one that has been (or is likely to be) present for six months or longer, for example, asthma, cancer, cardiovascular disease, diabetes, musculoskeletal conditions and stroke. There is no list of eligible conditions; however, the CDM items are designed for patients who require a structured approach, including those requiring ongoing care from a multidisciplinary team.
How do I find out if I am eligible for a plan?
Whether a patient is eligible for CDM services is a clinical judgement made by the GP, which takes into account the patient’s medical condition (s) and care needs, as well as the general guidance set out in the MBS.
Patients who have a chronic medical condition and complex care needs and are being managed by their GP under a GP Management Plan (item 721) and Team Care Arrangements (item 723) are eligible for Medicare rebates which subsidise certain allied health services on referral from their GP.
What access do I have to allied health services?
Referrals for allied health services may entitle you for subsidised Medicare rebates for specific individual allied health services that your GP has identified as part of your care. The need for these services must directly relate to your chronic medical (or terminal) condition. It is best to check with your GP as to what this entails for you.
If you have diabetes and your GP has prepared a plan for you, you can also be referred for certain allied health services provided in a group setting.
How do I organise a plan?
Our highly skilled, caring and experienced medical practitioners and nurses can personalise a care plan to specifically suit your needs to help you better manage your condition.
Book an appointment today at Toukley Family Practice and let us help you better manage your health and enhance your quality of life.
Australian Department of Health