Latest poll shows low engagement still an issue, as government defers promised new item numbers until July…

One year after the launch of MyMedicare, 60% of GPs believe there is not enough engagement for the program to succeed, a national Healthed survey of more than 1600 GPs has found.

This is a slight improvement from a year ago when 68% of surveyed GPs predicted the initiative would not get enough engagement to succeed.

The results come despite broadly positive sentiments about MyMedicare, with 59% seeing it as an either somewhat (48%) or very positive (11%) development for general practice.

Yet while most practices have registered for the initiative, getting patients on board continues to be a struggle. Healthed’s survey found:

• 39% of GPs whose practices participate in MyMedicare said very few to none of their patients had signed up.
• 12% said most or all their patients were registered.

According to the Department of Health and Ageing, over 1.8 million patients have registered with MyMedicare so far – to put that in perspective, there are more than 11 million Australians living with one or more chronic diseases.

New MBS item numbers deferred

Meanwhile, changes to MBS item numbers that had been set to take effect on 1 November have now been deferred until 1 July 2025, “to support all practices and providers, including GPs and allied health providers, to be ready for the changes,” a spokesperson for the Department told Healthed. This includes preparing practice software to support the new chronic disease management plan, they added.

Unclear value proposition for patients

Many GPs in Healthed’s survey said it just isn’t clear what’s in it for patients.

Dr Joe Kosterich, a WA GP and media commentator says that not that many patients in his practice have signed up, and while the now-deferred changes to care plans might help, at this stage there’s just not enough to incentivise them.

“Most patients are going to say, well, what do I get for this? And as we sit here today, we don’t get anything,” he says, noting that the longer telehealth consultation currently available to registered patients is very rarely used.

“So to say to people, oh, you should sign up for MyMedicare, the first thing they’re going to say is why. And then it’s not a particularly easy sell.”

“Because they’re going to say, well, there’s nothing for me. And to be fair, at the moment, there isn’t. Now, when it reaches the point that, basically when you can dangle in front of them their five free podiatry visits, if you don’t sign up, you won’t be entitled to that, they’ll start signing up.”

“As soon as there’s some incentive for them to do it, I suspect you’ll see more will sign up.”

A balance between choice and continuity of care

Professor Karen Price, past president of the RACGP, GP and researcher, agrees that it’s a tough sell.

“Many patients, particularly older patients with chronic health conditions, have a practice that they go to and most likely within that practice, they have a favourite and a second favourite GP. That’s a pretty standard experience for many people now. So from the patient’s point of view, how do you sit there as a doctor and say, look sign up to this, you’re not going to be any better off?”

She reckons more vulnerable patients will need “a lot bigger trust in what that means,” while it’s unclear how it will affect young, highly mobile folk who travel for education or work.

“So it’s seen to be reducing choice, yet we also want to promote continuity of care,” Professor Price says.

“Without any big dollars behind it for patients, in terms of being able to access levels of care, unless it’s in the patient’s best interests, I can’t see it taking off at this point,” she says, caveating that the government had acknowledged the importance of patient value, with this as the first iteration.

“So I guess we wait and see, but we’ve been waiting and seeing for a long time and I really think it’s time to take some action in promoting respect for general practice,” she sums up.

Several GPs in the survey shared this sentiment, with a number citing patients’ concerns about the lack of flexibility.

“So far patients are not happy with this idea, believing they are locked in to one practice and cannot be seen in other practices,” one GP said.

Yet while GPs lack confidence that the program will succeed, many would like it to

Still despite their overall pessimism that the initiative will work, the majority of GPs do see it as a somewhat positive development.

It could lead to better patient and GP relationships, and offer benefits for those with chronic and complex health conditions, surveyed GPs commented.

“Positive for better billing for GPs with mental health consults, telehealth and ongoing check-ups for elderly patients who can’t come into practice,” one GP noted.

“It’s a promising initiative that would likely have a positive impact on patients care, especially for patients with complex chronic health conditions,” another said.

What changes can we expect next year?

From 1 July 2025, a single GP Chronic Condition Management Plan MBS item number will replace the current GP Management Plan and Team Care Arrangements. Patients who are registered for MyMedicare will be required to access management plans through the practice where they are registered.

Reviewing management plans will attract the same fees as developing them, and patients must have their plan reviewed within 18 months to continue accessing allied health and other services, among other changes.

What’s being done to increase engagement?

A spokesperson for department of health and ageing says “a practice-led registration strategy is being undertaken to target patient centred communication, which focuses on those eligible to receive the longer MBS telehealth items linked to MyMedicare, and other benefits.”

“As additional incentives are linked to MyMedicare, it is expected that patient registrations will grow for those eligible populations,” they said.

“The General Practice in Aged Care Incentive launched on 1 July 2024. Eligible GPs and Practices registered with both MyMedicare and the General Practice in Aged Care Incentive are able to receive incentive payments. The Incentive is designed to better support older people living in aged care to access regular visits and quality patient-centred planned care.”

What your colleagues are saying

“Patients are confused and I think there will be a lot of poaching to sign up people who go to different practices.”

“For mixed billing practices, there will be an incentive for patients to sign up.”

“Lack of government advertising to consumers and therefore lack of knowledge – much staff time “wasted” explaining this. Stupid for the patient to have to nominate a specific doctor – what if they leave practice or are on longer term leave? Few if any current benefits to practice – the majority of our patients are long term – many 40 years plus!”

“Patients can’t access their usual GP at the best of times.”

“Beware capitation.”

“Concept is good, but implementation as always is terrible.”

“At least patients who belong to the practice won’t have care plans done by a random practice.”