Doctors may find the new MyMedicare aged care incentive annoying, but that hasn’t gotten in the way of registering patients.
Despite early analysis indicating that GPs are largely unsatisfied with the MyMedicare-tied General Practice in Aged Care Incentive (GPACI), uptake of the initiative has exceeded the commonwealth’s modelling.
A spokesman for the Department of Health, Disability and Ageing confirmed with The Medical Republic that it had projected 89,000 patients would be registered for GPACI in its first year, with that number rising to 97,000 in total registered by the end of the incentive’s second year.
Twelve months in, though, and the number of patients registered for the aged care incentive has already topped 114,000.
This is despite several perceived flaws with the system on GPs’ end.
“The program itself has good intentions, but the implementation has been a problem,” RACGP aged care specific interests chair Dr Anthony Marinucci told TMR.
GPACI replaced the existing Practice Incentive Payment – Aged Care Incentive in July last year and is the first incentive payment to be tied to voluntary payment enrolment system MyMedicare.
The incentives work slightly differently; under the new version, for instance, there’s no upper cap on how much GPs can earn via the scheme, and there are payments to practices where previously the money went entirely to GPs.
According to an early insights report from Nous Group published last week, GPs described the registration process and tracking of service delivery per patient as “overly burdensome”.
“Overall, the fact that the government has realised that there needs to be support in the area, I think, is a very, very positive thing,” Dr Marinucci said.
“One of the most important things that this incentive aims to address is the fact that a lot of primary care work in the aged care industry is unbillable and unpaid.
“And this is what this sort of payment is addressing.
“What a lot of GPs are offside about is that they feel the actual payment they get, which is $300 [per patient per year], is inadequate.”
Polling done by the college itself put the expected payment closer to $1000 per patient per year.
Associate Professor Joel Rhee, a GP and researcher with a special interest in aged care, told TMR that the administrative burden of the GPACI was worsened by the fact that practices often have to take on the job of registering patients for MyMedicare.
“To register for MyMedicare, patients can either do it themselves, get their [carer] to do it, or ask the practice to do it,” Professor Rhee said.
“But … most patients who are unwell enough to go into residential aged care are not going to be able to register themselves, and many of their carers also don’t really have the capacity to do that, so it falls entirely upon on the practice to do it.
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“Even inputting the information into PRODA … is not a straightforward process. It requires time and it’s not bug free.”
Dr Marinucci said he faced the same issue with registering patients and estimated that less than 1% of his aged care patients had been able to register themselves in MyMedicare.
“For me personally, one of the biggest hurdles to achieving GPACI has been the administrative burden,” the RACGP aged care chair said.
“The reason that I don’t get it for all my patients is purely the fact that they simply haven’t been signed up and I’ve struggled to sign them up from either the fact that I haven’t been able to find their next of kin or purely for the fact that they are unable to sign the forms.”
Adding insult to injury is the fact that the old PIP scheme required virtually no admin on the GP end, Professor Rhee said.
According to Professor Rhee, who is also leading the research project that will evaluate GPACI, signing patients up was not the only hurdle.
“If you provide care to patients and see them face to face at least two times in in a three-month period, and if you provide certain proactive treatments to patients over a 12-month period, then you can qualify for the payments,” Professor Rhee said.
“That sounds quite easy, but when you actually then try to implement it there are more rules around how the department calculates the payments and that kind of thing, so it can become really tricky.”