A look at Enhanced Primary Care (EPC) 2.5 years on

It is now 2.5 years since the MBS items for health assessments, care planning and case conferencing were introduced and statements such as “who has the time?” were the catch cry amongst our GP community. So, let’s have a look at where EPC is now.

Some GPs quickly took up health assessments and their uptake continues to grow in many practices. Many different models are employed through the Northern Rivers, including GPs, completing the whole process or practice nurses or private nursing providers partially completing the assessment before the GP does a physical examination and medication review.

Feedback from both patients and GPs has been overwhelmingly positive on the whole process. To give some indication of the number of health assessments being undertaken, 495 were completed in the January-March quarter this year, with 13% at the patient’s home.

Care planning
Care planning, which may seem to be a little more involved, was embraced more slowly. As a consequence, the Commonwealth linked care plans with a Practice Incentive Program (PIP) payment in November 2001. This incentive seems to have had a motivating effect with care plans increasing by 514% in the Northern Rivers in the January-March quarter compared to the same period last year.

In the Northern Rivers, 432 community care plans were completed last quarter, followed by 346 care plan reviews. This overwhelming response and increase in care plans means that the care planning incentive will stop in November 2002, 12 months ahead of schedule. The MBS care plan items will continue with a scheduled rebates. For further information about the care planning incentive payment and timelines for inclusion please request Care Planning PIP fax sheet from the division.

Discharge care plans
Discharge care plans continue to be slow due to the VMO restrictions imposed in the criteria. These appear to be disadvantaging rural and remote areas to a degree because of the nature of the health system we operate in. This issue continues to be presented to the Commonwealth on a regular basis, especially with regard to contributing to a care plan that has been developed by a discharge coordinator.

The uptake of case conferencing items has been much slower but this is not particularly surprising considering the case conferencing items do require two other health professionals to align with a GP at a particular time. Many health professionals see the case conferencing items as useful for urgent health matters that need a brisk response or plan. It is anticipated that these will increase with the soon to be released mental health initiatives.

So how do GPs in the Northern Rivers compare with their colleagues throughout the State?

GPs using EPC items

	NRDGP	State
Jan-Mar 2001	26%	23%
Jan-Mar 2002	38%	44%

The mental health initiative will roll out in late June. This initiative will include mental health MBS items and incentives.

Assistance to implement the EPC MBS items in your practice is available by contacting Beth Heldt at the division on phone 6622 4453. There are several MD templates for care planning available and Beth can provide assistance in setting up a system or process in your practice.

Beth Heldt