New MBS item 699 for Heart Health Check failed industry expectations.

Heart Check item has been introduced on the 1 April 2019. The date could not have been picked better.

The descriptor for this item says:

Professional attendance for a heart health assessment by a general practitioner at consulting rooms lasting at least 20 minutes and must include:

(a) collection of relevant information, including taking a patient history that is aimed at identifying cardiovascular disease risk factors, including diabetes status, alcohol intake, smoking status, cholesterol status (if not performed within the last 12 months) and blood glucose; 

(b) a physical examination, which must include recording of blood pressure;

(c) initiating interventions and referrals to address the identified risk factors; 
(d) implementing a management plan for appropriate treatment of identified risk factors; 
(e) providing the patient with preventative health care advice and information, including modifiable lifestyle factors;

with appropriate documentation.
MBS benefit: 85% = $72.80

Does everyone see what many other doctors see here? The item’s benefit is equal to one for long consultation – item 36. Let us add timing to each action required for this item.

Professional attendance for a heart health assessment by a general practitioner at consulting rooms lasting at least 20 minutes and must include:

(a) collection of relevant information, including taking a patient history that is aimed at identifying cardiovascular disease risk factors, including diabetes status, alcohol intake, smoking status, cholesterol status (if not performed within the last 12 months) and blood glucose; 

Explaining to the patient what is proposed, why and getting consent and perform actions required above – estimated time 15 min

(b) a physical examination, which must include recording
of blood pressure

5 min

(c) initiating interventions and referrals to address the identified risk factors
(d) implementing a management plan for appropriate treatment of identified risk factors; 
(e) providing the patient with preventative health care advice and information, including modifiable lifestyle factors – 15 min – 20 min as it requires printing out the relevant materials and explaining them to the patient e.g. effects of cholesterol on blood vessels etc

with appropriate documentation – 10 min if the template is used.
The consensus among GPs is that the total time required to perform this assessment is 45 – 50 minutes.

Conclusion: The item fails to reflect on the volume of work that needs to be performed. The requirements do not match the level of reimbursement.