Apuntes de Crecimiento Económico, Sala I Martín, Javier, 1994.

Use of Medicare item 710 by some Aboriginal Community Controlled Health Services has already resulted in greater use of the Medicare and Pharmaceutical Benefits schemes by Aboriginal and Torres Strait Islander patients. Using this and other Medicare items can gain funding and improve outcomes but may not be feasible in all settings.

Medicare item 710

The Aboriginal and Torres Strait Islander adult health check should generally be undertaken by the patient’s ‘usual doctor’. This means the doctor (or a doctor working in the medical practice or health service) who has provided most of the services the patient has had in the past 12 months and/or who will provide most of the services for the patient in the next 12 months.

The information collection component of the assessment may be completed by an Aboriginal Health Worker, nurse or other qualified health professional where:

❖ the patient’s medical practitioner has initiated the collection of

information by a third party, after the patient has agreed to the Adult Health Check and has agreed to a third party collecting information for the assessment

❖ the patient is told whether or not information collected about them

for the health check will be retained by the third party

❖ the third party acts under the supervision of the practitioner.

The other components of the health check must include a personal attendance by the medical practitioner.

Within the general practice or primary health care service a number of organisational and structural issues could be considered in order to facilitate effective implementation of the Aboriginal and Torres Strait Islander Adult Health Check item. These include:

❖ clearly defining roles of individuals within the health team who will

be undertaking elements of the health check and follow-up

❖ ensuring all members of the health team who are involved in

undertaking the health check understand the elements of the health check, and are given adequate information to undertake their role, including cultural awareness training as appropriate;

❖ timing health check appointments so that components of the health

check can be undertaken by appropriate staff — some health checks may require more than one visit to complete

❖ use of formal (ideally electronic) recall and reminder systems to

ensure follow-up of patients

❖ use of standard protocols and evidence-based guidelines for

screening, follow-up, referral and treatment

❖ continuous quality improvement processes to review progress and

implement changes where appropriate

Strengthening Cardiac Rehabilitation and Secondary Prevention for Aboriginal and Torres Strait Islander Peoples A Guide for Health Professionals

148 Toolkit 4 – Materials for managers of health organisations

Medicare chronic disease management items

There are six chronic disease management Medicare items.

Preparation of a GP Management Plan (Item 721)

❖ Provides a rebate for a GP to prepare a management plan for a

patient with a chronic or terminal condition (including patients who have multiple chronic conditions and multidisciplinary care needs).

❖ Recommended frequency is once every two years, supported by

regular review services.

❖ The GP (who may be assisted by an Aboriginal Health Worker or

practice nurse) assesses the patient, agrees management goals, identifies actions to be taken by the patient, identifies treatment and ongoing services to be provided, and documents these in the GP Management Plan.

Review of a GP Management Plan (Item 725)

❖ Provides a rebate for a GP to review a GP Management Plan.

❖ Aboriginal Health Worker or other can assist.

❖ Recommended frequency is once every six months; can be earlier

if clinically required.

❖ Involves reviewing the patient’s GP Management Plan,

documenting any changes and setting the next review date.

Coordination of Team Care Arrangements (Item 723)

❖ Provides a rebate for a GP to coordinate the preparation of Team

Care Arrangements for a patient with a chronic or terminal medical condition who also requires ongoing care from a multidisciplinary team of at least three health or care providers.

❖ In most cases the patient will already have a GP Management Plan

in place but this is not mandatory.

❖ Recommended frequency is once every two years, supported by

regular review services.

❖ Involves a GP (who may be assisted by an Aboriginal Health

Worker or practice nurse) collaborating with the participating providers on required treatment/services and documenting this in the patient’s Team Care Arrangements.

Coordination of a Review of Team Care Arrangements (Item 727)

❖ For patients who have a current Team Care Arrangement and

require a review of their Team Care Arrangement.

❖ Recommended frequency is once every six months; can be earlier

if clinically required.

❖ Involves the GP (who may be assisted by their Aboriginal Health

Worker or practice nurse) collaborating with the participating providers on progress against treatment/services and documenting any changes to the patient’s Team Care Arrangement.

Strengthening Cardiac Rehabilitation and Secondary Prevention for Aboriginal and Torres Strait Islander Peoples 149 Toolkit 4 – Materials for managers of health organisations

Contribution to a multidisciplinary care plan being prepared by another health or care provider (Item 729)

❖ For patients who are having a multidisciplinary care plan prepared

or reviewed by another health or care provider (other than their usual GP).

❖ Recommended frequency is once every six months; can be earlier

if clinically required.

❖ Involves the GP (who may be assisted by an Aboriginal Health

Worker or practice nurse) collaborating with the providers preparing or reviewing the plan and including their contribution with the patient’s records.

Contribution to a multidisciplinary care plan being prepared by another health or care provider for a resident of an aged care facility (Item 731)

This is for patients in residential aged care facilities and is otherwise the same as item 729.

Further information

❖ Further information about Medicare item 710 is available from:

www.health.gov.au/epc

❖ Information on the chronic disease management items is available

from: www.health.gov.au/internet/wcms/publishing.nsf/Content/ pcd-programs-epc-chronicdisease

Strengthening Cardiac Rehabilitation and Secondary Prevention for Aboriginal and Torres Strait Islander Peoples A Guide for Health Professionals

150 Toolkit 4 – Materials for managers of health organisations