The General Practice in Aged Care Incentive (GPAI) program, starting on 1 July 2024, offers significant benefits for eligible general practitioners (GPs) and practices. The program aims to enhance healthcare services for older people in residential aged care homes by providing financial incentives for GPs and practices to offer regular visits and comprehensive care planning.
Importance of the Incentive
The GPAI is designed to:
- Improve the continuity of care for aged care residents.
- Reduce avoidable hospitalisations.
- Ensure that older people in residential aged care receive consistent and regular medical attention.
Incentive Payments
Incentive payments will be provided quarterly in addition to existing Medicare Benefits Scheme (MBS) and Department of Veterans’ Affairs (DVA) rebates. To qualify for these payments, GPs and practices must:
- Be registered with MyMedicare.
- Meet the GPAI eligibility and servicing requirements.
Payment Structure
- GPs: $300 per patient per year.
- Practices: $130 per patient per year.
- Payments are subject to rural loadings for Modified Monash Model (MMM) regions MMM 3 to MMM 7.
Eligibility Criteria
Practice Eligibility
- Must be registered with MyMedicare, including providing banking details.
- Must be registered with the General Practice in Aged Care Incentive.
GP Eligibility
- Must be an eligible primary care provider as outlined in the Program Guidelines.
- Must be linked to an eligible practice.
- Must be declared as the responsible GP for eligible services to registered patients, coordinating the care team or practice services.
Patient Eligibility
- Must permanently live in a residential aged care home (excluding respite care).
- Must be registered with MyMedicare and linked to an eligible practice and responsible GP.
- Must have the GPAI indicator selected on their MyMedicare profile by their practice.
Servicing Requirements
To receive incentive payments, responsible GPs and practices must meet specific servicing requirements, including:
- Delivering two eligible care planning services over a 12-month period.
- Providing two eligible regular visits per quarter, each in a separate calendar month, totalling at least eight regular services in a 12-month period.
Eligible services encompass a range of MBS and DVA items as detailed in the Program Guidelines.
Quarterly Visits
- Services must be under the responsibility and direction of the responsible GP.
- At least one of the regular visits must be provided by the GP, with the second visit delivered by the GP or another member of the patient’s care team, such as an alternate provider within the same practice, GP registrar, nurse practitioner, or Aboriginal and Torres Strait Islander health practitioner or worker.
Modified Monash Model Areas (MMM 4 to MMM 7)
- If registered patients cannot attend face-to-face services, practices in these areas can provide up to four regular visits per 12-month period using eligible telehealth MBS items.
The GPAI is an important step toward ensuring that residents of aged care receive consistent and thorough medical care, aiming to improve their overall health and well-being.
Summary of Eligibility
Practice Eligibility
- Registered with MyMedicare, including banking details.
- Registered with the General Practice in Aged Care Incentive.
GP Eligibility
- Must be an eligible primary care provider as per the Program Guidelines.
- Linked to an eligible practice.
- Declared as the responsible GP for eligible services to registered patients.
Patient Eligibility
- Permanently live in a residential aged care home (excluding respite care).
- Registered with MyMedicare and linked to an eligible practice and responsible GP.
- General Practice in Aged Care Incentive indicator was selected on the MyMedicare profile based on their practice.
Servicing Requirements
- Two eligible care planning services over a 12-month period.
- Two eligible regular visits per quarter, each in a separate calendar month, totalling at least eight regular services in a 12-month period.
- At least one regular visit is provided by the responsible GP.
- The second visit can be provided by the GP or another patient care team member (alternate provider within the same practice, GP registrar, nurse practitioner, or Aboriginal and Torres Strait Islander health practitioner or worker).
Modified Monash Model Areas (MMM 4 to MMM 7)
- Up to four regular visits per 12-month period using eligible telehealth MBS items if patients cannot attend face-to-face services.