The proposal comprises three components to manage chronic diseases in the Australian population by enrolling a specified number of patients in an ongoing chronic disease management scheme. The proposal would have effect from 1 July 2019. It would operate in addition to the incentives for general practitioners (GPs) implemented in the 2019-20 Budget measure Guaranteeing Medicare – strengthening primary care.

Up to 500,000 patients per year with physical health issues and up to 500,000 patients per year with mental health issues would be enrolled. There would be 700,000 enrolled patients in 2020 and one million per year thereafter.

• Component 1 – make an annual payment to GPs of $1,000 per enrolled patient in return for enrolling patients in the new chronic disease management scheme (the new scheme).
• The payments would compensate GPs for time spent managing, planning and coordinating the care of the patient, including with allied health providers. Payments would be conditional on health benchmarks being met; these would be set by the Department of Health and local Primary Health Networks.
• The proposal would also phase out specified chronic disease management items in the Medicare Benefits Schedule (MBS) for patients enrolled in the new scheme. Lists of the items affected by each health stream are at Attachment A. These would be phased out as follows:
  • year 1 – no change
  • year 2 – remove access to half of the relevant MBS items (details to be agreed in consultation with stakeholders as part of implementing the new scheme)
  • year 3 – remove access to all of the relevant MBS items.
• Patients enrolled in the chronic physical health stream would continue to have any mental health issues treated through existing MBS items. Similarly, patients enrolled in the chronic mental health stream would continue to have any physical health issues treated through existing MBS items. Patients not enrolled in the new scheme would continue to have access to all MBS items.
• Component 2 – develop risk profiles, template management plans, funding recommendations, and administrative and reporting systems to support the new scheme.
• Component 3 – provide a pool of funds to Primary Health Networks, equivalent to $750 for each enrolled patient visiting allied health providers (such as physiotherapists, nutritionists, nurses and psychologists), for the purpose of subsidising visits.