Chronic Disease Care Plans

Chronic Disease Care Plans

If you suffer from a chronic disease and the management of it requires some planning and follow up, your doctor may suggest a chronic disease care plan.

This is a good way of not losing focus over the management of your condition in the long term. Sometimes life just gets in the way, or lots of little issues pop up and before you know it it’s been a year since someone has reviewed your diabetes, or your crohn’s disease has gone unchecked.

As chronic disease is affecting more and more of us, keeping on top of it and preventing long term complications is paramount to live a healthy and fruitful life.

What is a care plan?

It’s when a doctor, nurse or both sit with you and establish what the goals are for your condition. If you suffer diabetes, one main goal would be to achieve stable and acceptable long term blood glucose levels. An overarching longer term goal would be to avoid the microvascular and macrovascular complications like kidney failure or heart disease. But the plan really lets us make sure we follow up and get down to the nitty gritty of it all.

At GS Health the plan is initiated once the doctor feels you would benefit from more regular follow up. Given that this is a priority in our health system these care plans are bulk billed – meaning that there is no out of pocket expense to you.

Team care arrangements

If the management of your condition requires input from several health professionals, then it’s best we work together as a team with your GP guiding the strategy. When you require the help of at least 3 people (often your GP, maybe a specialist and maybe an allied health practitioner) then we initiate a team care arrangement.

This is formed off the goals of the care plan, but specifically asks for external help.

One benefit of a team care arrangement is that in the 12 months from when we initiate it, medicare provides up to 5 rebated sessions with certain allied health providers. This means your consult with them is cheaper by $52.95 if that practitioner has a provider number with medicare. This helps with some of the financial burden of the extra care required to keep people healthy

What are the costs?

For regular patients of GS Health, the care plans are bulk-billed – meaning that we accept the medicare rebate as the total payment. This means at your care plan appointment there will be no out of pocket cost to yourself.

We cannot provide a care plan on the first appointment we’ve met someone, as it is only to be used by your regular treating doctor or clinic.

Sounds great! Book me in!

Now let’s just wait a minute.

Care plans are very useful, but not necessary for everyone. If your chronic disease is already managed really well, then there’s no point adding extra appointments or paperwork to do what we’re already doing. Your doctor will let you know if we think you’d benefit from a care plan.

The same goes for the team care arrangements. While it sounds nice to get some money back from physio or get the see the podiatrist, these plans are only for people who need it to manage their chronic disease and should be initiated by the doctor.

It is not a reverse referral system where if you see a physio for a sore back following an injury, then they ask you to see your GP for a care plan or team care arrangement. Some people are still confused about the rules regarding this, but medicare is very strict and fraudulent usage of this service can result in severe penalties for your health provider.

Please don’t ask us to do something that puts us in an awkward situation.

If you think you may benefit from a care plan or team care arrangement, please bring it up with your doctor if they haven’t already brought it up with you.

Chronic Disease

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