Update on Medicare-funded allied health chronic disease management consultations in dietetics and the five most referred professions in 2010

2012 ◽  
Vol 70 (1) ◽  
pp. 42-48 ◽  
Author(s):  
Robyn P. CANT ◽  
Michele M. FOSTER
2012 ◽  
Vol 2012 ◽  
pp. 1-7
Author(s):  
Kay Jones ◽  
Trisha Dunning ◽  
Beth Costa ◽  
Kristine Fitzgerald ◽  
Akuh Adaji ◽  
...  

Background. In Australia most chronic disease management is funded by Medicare Australia through General Practitioner Management Plans (GPMPs) and Team Care Arrangements (TCAs). Identified barriers may be reduced effectively using a broadband-based network known as the Chronic Disease Management Service (CDMS). Aims. To measure the uptake and adherence to CDMS, test CDMS, and assess the adherence of health providers and patients to GPMPs and TCAs generated through CDMS. Methods. A single cohort before and after study. Results. GPMPs and TCAs increased. There was no change to prescribed medicines or psychological quality of life. Attendance at allied health professionals increased, but decreased at pharmacies. Overall satisfaction with CDMS was high among GPs, allied health professionals, and patients. Conclusion. This study demonstrates proof of concept, but replication or continuation of the study is desirable to enable the impact of CDMS on diabetes outcomes to be determined.


2010 ◽  
Vol 34 (1) ◽  
pp. 30 ◽  
Author(s):  
Terry P. Haines ◽  
Michele M. Foster ◽  
Petrea Cornwell ◽  
Jennifer Fleming ◽  
Sean Tweedy ◽  
...  

Objective.To evaluate new pathways to access allied health services introduced by the Enhanced Primary Care/Chronic Disease Management (EPC/CDM) initiative that may both increase or decrease equity to and efficiency in access. Design.A qualitative study consisting of semi-structured in-depth interviews with a purposively selected group of allied health practitioners. Participants and setting.Allied health practitioners in private practice in Queensland, Australia, from physiotherapy, occupational therapy, speech pathology, and exercise physiology backgrounds (n = 15). Main outcome measures.Interviews focused upon several issues including how referrals are made under the EPC/CDM initiative and what happens for patients once their five allotted sessions are expended. Results.The EPC/CDM initiative appeared to address two key barriers of access to allied health services – costs to patient of access and patient awareness of benefits. However, gap payments may still be deterring economically disadvantaged patients from attending. Discussion.The EPC/CDM initiative is increasing access to allied health services for people with chronic diseases. However, it is evident that this initiative may still not be meeting the needs of those most disadvantaged economically, and may lead to duplication of efforts by allied health practitioners when patients move between private and public health care sectors. What is known about the topic?Publicly funded subsidy of allied health services for people with chronic disease is a relatively new policy initiative in Australia. The success of such policy hinges on several factors, notably, its ability to improve equity of access to appropriate health care, generate improved health outcomes, and to do so efficiently. What does this paper add?This paper demonstrates how health professionals and patients are actually using the Enhanced Primary Care/Chronic Disease Management initiative to access allied health services. The strengths and weaknesses of current policy identified will inform future policy development and funding decisions. What are the implications for practitioners?Equitable access to allied health services for people with economic disadvantage is still limited due to gap payments. This initiative has facilitated patient exposure to the benefits of allied health services first hand, prompting some to continue paying for these services privately once the annual number of sessions permitted are exhausted.


2011 ◽  
Vol 35 (4) ◽  
pp. 468 ◽  
Author(s):  
Robyn P. Cant ◽  
Michele M. Foster

Objective. To critically examine utilisation of the 13 allied health services provided through Medicare Chronic Disease Management program and related general practitioner (GP) care planning initiatives. Methods. Statistics generated from national billing data from July 2005 to June 2009 were extracted from Medicare data and compared by profession, State or Territory and population. Results. Most services grew over 4 years although nationally consistent service levels were not found for any allied health provider profession. On referral from GPs, podiatry, physiotherapy and dietetics provided most services (82%) in 2008–09. Professions had unique patterns of referral instanced by age range and sex of clientele. Wide variation was apparent in per capita utilisation of allied health services by State or Territory; some with far less than average national use and others with high use. Annual number of GP Management Plans or Team Care Arrangements was low (mean: ≤22 per GP in 2008–09), indicating low use of care planning. Conclusion. Inequality of accessibility for patients was apparent. Five years into the program, a review of Medicare Allied Health CDM policy is warranted. Implications. Research and evaluation is needed to identify whether the program is meeting the needs of GPs, allied health providers and chronic disease patients. What is known about the topic? Since 2004, Medicare Chronic Disease Management program has offered Australian patients with chronic or complex disease access to 13 allied health professions via private clinics on referral from their general practitioner – with costs subsidised by Medicare. Little is known about the demographics of referred patients or which allied health services are utilised. What does this paper add? We take a multidisciplinary perspective to describe program use and find wide variation by profession nationally. Per capita State and Territory data indicate inequality of accessibility. Podiatry, physiotherapy and dietetics provided 82% of all services in 2008–09. Referrals initiated by GPs via patient care plans are increasing, but at present referrals per each GP are low. What are the implications for practitioners? More needs to be known about the dynamics that affect referral, the local accessibility of allied health providers and issues that affect uptake by patients.


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