Empowering Healthcare: Unveiling MyMedicare – Your Pathway to Enhanced Patient Care and Practice Growth

MyMedicare is a new voluntary patient registration system being introduced by the Australian Government as part of its response to the Strengthening Medicare TaskForce to enhance the relationship between patients, general practices, GPs, and primary care teams. The focus is on continuity of care, especially given the challenges posed by an aging population and rising chronic illness rates, highlighting its vital role in our healthcare system. Participation is voluntary for patients, practices, and providers and will have benefits such as longer telehealth consultations to registered MyMedicare patients. This enhances the flexibility and accessibility of care, and could indirectly contribute to the practice’s patient retention and satisfaction rates.

Understanding MyMedicare

The importance of MyMedicare lies in the benefits it offers to both patients and practices. Registered patients gain improved continuity of care with their chosen practice, longer Medicare Benefits Schedule (MBS) funded telephone calls with their usual general practice, and increased bulk billing incentives for telehealth consultations for children under 16, pensioners, and concession card holders. Practices benefit by gaining more information about their regular patients, facilitating tailored services, and accessing new telehealth items and incentives.

Eligibility criteria apply for both general practices and healthcare providers to join MyMedicare.

General practices must:

• Provide Medicare-funded services
• Be registered in Services Australia systems; Provider Digital Access (PRODA), Health Professional Online Services (HPOS), and the Organisation Register
• Have at least one eligible provider linked to the practice in the Organisation Register. Eligible providers can be a vocationally registered GP, non-vocationally registered GP or a GP registrar, and
• Be accredited under the National General Practice Accreditation Scheme – non-accredited practices will have 12 months to register with an accreditation agency and gain accreditation.

Accreditation exemptions are available for specific scenarios until 30 June 2025, such as those offering general practice services through mobile and outreach models in rural settings, residential aged care, disability residential settings, to First Nations Australians, and to people experiencing homelessness.

Healthcare providers must be a GP (vocationally registered GPs, non-vocationally registered GPs, GP registrars) or nurse practitioner and must:

• Work at a MyMedicare eligible practice
• Be linked to the practice on the Organisation Register
• Have a valid provider number and be eligible to deliver Medicare Benefits Schedule (MBS) or Department of Veterans’ Affairs equivalent services.

Only patients registered with MyMedicare and registered with your practice will be able to claim the rebates and benefits on offer, so practices are encouraged to assist with patient registration.  Leveraging these benefits enables enhanced healthcare access for patients and facilitates more comprehensive care delivery by practices.

How to register

From 1 July 2023, general practices can initiate the MyMedicare registration by ensuring eligibility and linking their organisation in PRODA to HPOS. The Organisation Register in HPOS should then be accessed to register the practice and link eligible providers. If the practice is already registered and providers are linked in the Organisation Register, a second registration is unnecessary. Once these steps are done, no further action is required until patient registration opens in October 2023.

How to enrol patients

From 1 October 2023, patients can register for MyMedicare using their Medicare or Department of Veterans’ Affairs (DVA) Veteran card. Registration can be done online or in-person at their registered practice.

General Practice in Aged Care Incentive

The General Practice in Aged Care Incentive is designed to ensure consistent high-quality primary care for aged care residents by their regular GPs and practices. From 1 August 2024, GPs and practices registered in MyMedicare will receive incentives for delivering comprehensive care, including regular visits, to their registered patients in Residential Aged Care Homes (RACH). Access to this incentive does require MyMedicare registration, so if your practice serves aged care patients or plans to do so, registering for MyMedicare before 1 October 2023 will ensure continued quality care and eligibility for the incentive.

Frequent Hospital Users Incentive

The Frequent Hospital Users Incentive aims to help patients with chronic conditions access comprehensive community-based care and reduce hospital visits. This incentive is designed to help patients who present to a hospital 10 or more times a year, and will facilitate tailored multidisciplinary care for improved chronic disease management and patient outcomes. The payment details and eligibility criteria are currently being developed and the incentive is expected to start in FY2024-25 for selected regions and expanding nationally over three years. Registration in MyMedicare is essential for access to this incentive, so practices interested in the incentive’s potential benefits should consider registering for MyMedicare.

FAQs for General Practice

As a practice, why should I register for MyMedicare?

Practices that enrol in MyMedicare will gain improved patient insights, enabling tailored services. Registration also grants access to extended MBS telehealth services and new funding payments, enhancing continuity of care for better health outcomes through the provided information and benefits.

What is the timeframe to register for MyMedicare?

Registration for practices and providers in MyMedicare is optional and can be done at any time, however, practice and provider registration is a prerequisite for patient registration. After 1 November 2023, those not connected in MyMedicare won’t qualify for new extended telehealth rebates. From 1 July 2024, only those registered for MyMedicare will be eligible for the General Practice in Aged Care Incentive and the Frequent Hospital Users Incentive.

Should I register GP registrars and locums?

Yes, you can ensure their access to the associated MBS long telehealth items by registering them, allowing them to start from 1 November 2023. This process is quick and straightforward if you have their provider number on hand.

How do you define ‘mobile and outreach services’ for the purposes of the accreditation exemption?

The exemption aims to enable participation in MyMedicare for practices and providers without a main physical location for face-to-face services, operating through mobile and outreach models, encompassing areas like aged care, disability settings, rural and Indigenous communities, and homelessness. Eligibility requires alignment with the general practice model as defined by the RACGP.

Where do I find out more information about MyMedicare eligibility?

For additional details about practice registration, including eligibility, visit the Services Australia Health Professional Education website and follow the provided instructions. Providers with enquiries about their participation, including eligibility, should communicate with their practice for guidance.

How will MyMedicare improve the delivery of primary care in general practice?

The success of MyMedicare depends to a large extent on the crucial role of general practice and the acceptance by general practitioners, practice nurses, nurse practitioners, and other members of the care team in our healthcare system.  MyMedicare aims to offer blended funding to strengthen continuity of care and has the potential to improve patient care by cementing long term doctor-patient relationships and support by a multidisciplinary care team to deliver better experience and outcomes for patients. This support will enhance person-centred care, facilitate broader access to general practice, and aid practice sustainability. As part of this effort, initiatives like the General Practice in Aged Care Incentive and Frequent Hospital Users Incentive will begin in FY2024-25, contributing to these reforms.

Change management is crucial

A solid change management strategy and implementation plan is required – considering lessons learned from past programs. These need to include robust consultation with relevant stakeholders and consumers, incorporate practice redesign and readiness for change, innovation, capacity building in the health workforce, and training and support for practices.

The MyMedicare value proposition and benefits for practices, GPs, all care providers and patients, needs to be clear, along with what adjustments need to be made to support the implementation of this initiative.

 

More information

To find out more information on MyMedicare visit: https://www.health.gov.au/our-work/mymedicare

Australian General Practice Accreditation Limited (AGPAL) clients are able to access exclusive content and resources including our Coffee with Gary webinar series. To catch up on previous Coffee with Gary webinars, log in to your AGPAL Accreditation Hub to access all editions to date, including the latest July 2023 edition, RACGP 5^th edition updates that includes a section on MyMedicare.  All recorded webinars can be found within the EDUCATION & RESOURCES > WEBINARS > AGPAL WEBINARS : COFFEE WITH GARY section.