Last week, the Department of Health & Ageing (DOHA), released further information regarding the General Practice in Aged Care Incentive (GPACI).

What is GPACI?

The GPACI is aimed at supporting older people living in residential aged care. It helps them receive quality primary care services from their regular provider and practice, by providing eligible providers, who are registered with My Medicare and can deliver on service requirements, with incentives to see patients in a residential aged care home. Eligible practices and providers will be able to register through the My Medicare program from 1 July 2024.

Incentive payments

Payments are made quarterly:

$300 per patient, per year, paid to the responsible provider
$130 per patient, per year, paid to the practice

The incentive payments will be quarterly, on top of existing Medicare Benefits Scheme (MBS) and Department of Veterans’ Affairs (DVA) rebates for services delivered.

In any given assessment period (quarter), to be eligible to receive incentive payments, providers and practices must meet both eligibility and servicing requirements.

Eligibility criteria for practices

General practices must be an eligible practice and be registered in the:

Organisation Register
MyMedicare program (with banking details added)
General Practice in Aged Care Incentive program

Eligibility criteria for practices

Providers must be:

An eligible provider
Linked to their eligible practice
Declared as the responsible provider of eligible services to their eligible patient, including coordinating services provided by their care team

What you need to do:

To register and access the incentive your practice must be eligible and registered for MyMedicare. Your patients that are aged care home residents will also need to be registered for MyMedicare with your practice.

General Practices, and ACCHs/ACCHOs and other eligible practices will be able to start registering in MyMedicare for the General Practice in Aged Care Incentive from 1 July 2024.

In preparation, make sure you:

1. Register your practice with MyMedicare

2. Register your aged care resident with MyMedicare

Residents can register online, or by filling in a form and submitting it to your practice. Use these resources to communicate with residents about MyMedicare.

Be sure to:

Link your providers and your MyMedicare patients to your practice
Select the General Practice in Aged Care Incentive indicator on your patients’ MyMedicare profiles
Link patients to responsible providers in your practice

3. Prepare your practice and team to consider these questions:

Which General Practitioners will be your Responsible Providers and have ongoing responsibility for visiting patients in Residential Aged Care Homes?
Will any other members of your practice team also provide some of the visiting services to your Residential Aged Care home patients?
How will visits be planned and coordinated with your practice team and the residential aged care home?
- Will you schedule regular recurring visits to aged care homes into the calendars of your practice team?
- How will you communicate with the residential aged care home to confirm appointments, or handle enquires from the home if care advice is required in between visits?
Will your practice be accepting new patients from Residential Aged Care Homes?
- If so, consider contacting the aged care home to let them know and provide them with information they can share with patients about how to register with MyMedicare with your practice.If practices and residents are registered for the General Practice in Aged Care Incentive before 30 September 2024, eligible MBS and DVA items delivered during the full assessment quarter (July 2024 to September 2024) will be used to calculate entitlements for incentive payments.

Useful resources:

FAQ's from EMPHN recent Practice Managers Day

Q: Does obtaining paper consent from residential aged care patients and registering them under MyMedicare as their preferred GP qualify us for the incentive, or do the residents need to register our GP as their preferred provider via their MyGov account to formalise the relationship?

A: Practices and providers will be able to begin registering themselves for the General Practice in Aged Care Incentive through MyMedicare from 1 July 2024.

Practices will be required to link patients to responsible providers in their practice by selecting the General Practice in Aged Care Incentive indicator on their patients’ MyMedicare profiles through the Organisation Register program in HPOS used for MyMedicare.

Services Australia will soon publish education materials on the Services Australia Health Professional Education Resources website and the Services Australia MyMedicare e-Learning page to guide practices through the registration process in their systems.

Q: Does the requirement for two care planning sessions over 12 months and two eligible visits per quarter start 12 months before 1st July 2024? For example, if I meet these requirements for 50 patients from 1st July 2023, will I be eligible for the incentive, or does the period start from 1st July 2024 and meeting the requirements over the next quarter qualify me?

A: The first assessment period for eligible services for the General Practice in Aged Care Incentive will be from 1 July 2024 to 30 September 2024, with payments to be made in October 2024 if servicing requirements have been met during this quarter. Further details on the calculation of payments will be published in the coming days on the Department of Health and Aged Care website.

Q: How do mobile GP services (without physical clinics) achieve accreditation?

A: An accreditation exemption for MyMedicare practice registration is available until 30 June 2025. This is available to non-accredited practices (including sole providers) who deliver general practice services entirely through mobile and outreach models. Mobile GP services wishing to become accredited will need to contact an accreditation agency For more information please read this RACGP publication.

Further details for general practice and providers to review:

Payment criteria

The General Practice in Aged Care Incentive requirements will be outlined in the Program Guidelines.

Incentive payments will be:

Assessed
Calculated
Paid according to processes outlined in the Program Guidelines and Services Australia processes

Patient eligibility

Patients must:

Permanently live in a Residential Aged Care Home (RACH), not including respite care.
Register with the MyMedicare program and link to an eligible practice and responsible provider.
Have the General Practice in Aged Care Incentive indicator selected on their MyMedicare profile by their practice.

The responsibilities of practices and providers

It is the responsibility of providers and practices to ensure a patient is eligible.

They must declare their patient meets eligibility criteria for the incentive as part of the patient registration process.

Practices must:

Link providers and their MyMedicare patients to their practice.
Select the General Practice in Aged Care Incentive indicator on their patients’ MyMedicare profiles.
Link patients to responsible providers in their practice.

What are the servicing requirements?

Eligible providers and practices are required to meet the servicing requirements to be eligible for incentive payments, including delivering:

Two eligible care planning services over a 12-month period
Two eligible regular visits per quarter; each in a separate calendar month, delivering at least eight regular services in a 12-month period.
comprehensive medical assessment
contribution to, or review of, multidisciplinary care plan
multidisciplinary care conference (GP arranged or participated)
Residential Medication Management Review.
attendance at a RACH (Level B-E consultations or equivalent)
after hours services
nurse practitioner services
practice nurse and Aboriginal and Torres Strait Islander health practitioner and health worker services.
all servicing requirements outlined in the Program Guidelines
individual servicing requirements for each assessment quarter to be eligible for payment.
At least one of the regular visits must be provided by the responsible provider.
A second visit can be delivered by the responsible provider or another member of the patient’s care team. This includes:
- an alternate provider within the same practice
- GP registrar
- nurse practitioner
- Aboriginal and Torres Strait Islander health practitioner or health worker.

Care planning

The responsible provider must deliver at least two eligible care planning services within a 12-month period.

Eligible care planning includes a range of Medicare Benefits Schedule (MBS) and Department of Veterans’ Affairs (DVA) items in the following categories;

Regular visits

The responsible provider and their care team must deliver at least two eligible regular visits per quarter, delivered in separate calendar months, with a minimum of eight regular visits per 12-month period.

Eligible regular visits include a range of MBS items in the following categories;

Quarterly visits

Services must be delivered under the responsibility and direction of the responsible provider.

Providers and practices will be required to meet:

Telehealth

Practices located in Modified Monash Model (MMM) areas MMM 4 - 7 will be able to provide 4 four regular visits per 12-month period by eligible telehealth MBS items where they are unable to attend a face-to-face service.

I want to find out more:

MyMedicare | Eastern Melbourne PHN (emphn.org.au)

General Practice in Aged Care Incentive | Australian Government Department of Health and Aged Care