18 July 2025
EMPHN has released new resources to support your general practice in making small manageable changes and adapt to the new GP Chronic Conditions Management (GPCCM) MBS Items.
These resources are practical and designed to build on your existing commitment to quality improvement in the care you deliver for your patients with a chronic condition including:
- Encouraging MyMedicare registration for patients to enhance care continuity
- Clarifying team roles and enhancing your model of care
- Enhancing efficiencies and workflows
- Using data to quickly identify and engage patients
- Strengthening proactive care planning and regular reviews
- Enhancing communication for your practice and patients
CCM Quality Improvement (QI) Workbook:
The CCM QI workbook is a simple and practical guide for implementing CCM in General Practice settings through ongoing QI activities.
It focuses on enhancing continuity of care, improving patient outcomes and increasing practice efficiency through structured management planning and preventative care.
The workbook is designed to be applied practically. On page 3, a navigation page allows readers to navigate straight to the section most relevant to their team and complete activities in any preferred order.
CCM MBS User guide:
The CCM MBS User guide has been developed as a practical and easy-to-use reference for General Practices.
It demonstrates how to plan and deliver care for patients with chronic conditions using applicable MBS items relating to CCM. The resource provides a suggested cycle of care to incorporate an initial Chronic Condition Care Plan, with an ongoing review cycle that promotes continuity of care.
It contains live links to MBS items on MBS online, allowing practitioners to link from the resource to MBS online for further information on items if needed.
For support on MyMedicare, CCCM change queries, and quality improvement support, please contact practicesupport@emphn.org.au.
