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Next Steps
Once you have run the reports and are confident that your results are correct, consider the following questions to improve your practice systems and patient care:
General Questions
- Are we recording this information properly?
- Is our recall system working?
- Is our delivery of care sufficiently methodical or do gaps exist in our systems?
- Are we setting ourselves up for a high future workload with acute diabetic/CHD patients by constantly missing opportunities to intervene early?
What happens in your practice when a patient with diabetes - CHD walks in?
- Do you manage them according to a set plan, known by all GPs, Nurses and staff?
- Does the plan include clinical and billing items so that uniform care is delivered to each patient, and the practice does not miss claiming payments for work done.
- A patient on a plan is more likely to have confidence that his treatment is well in hand. As a result, they often present at the clinic less frequently.
What is the general condition of the patients with diabetes for whom you have an unknown HbA1c status?
- Are you missing the chance to be proactive in the management of these patients thereby setting yourself up for an acute management workload with these patients in the future?
- You could recall them, test them, claim MBS and PIP items and possibly save yourself an acute presentation at a later time. Patients that cause you stress also stress your reception staff, nurses and fellow patients. The opportunity to reduce future stress across the whole practice with smart work today should not be dismissed too rapidly.
How much income are you missing out on in the form of Diabetes Chronic Disease item no. payments?
Any effort put into the dual areas of identifying "hidden" diabetics, and ensuring known diabetics get comprehensive care, will be repaid in increased CDM payments from Medicare. This can be a significant sum.
| PRACTICE SITUATION |
| Number Active Patients in your Practice |
5000 |
| Expected Number Diabetics in your practice (Based on 7.5% of active population) |
375 |
| Service Incentive Payment (Annual Cycle of Care) |
$15,000 |
| Service Incentive Bonus >20% Diabetics treated |
$7,500 |
| GP Management Plan |
$45,000 |
| Team Care (Appropriate for 50% of Diabetics approx) |
$17,813 |
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| Total Value |
$85,313 |
Why is information that is vital to the good management of your patients with diabetes (HbA1c in this case) not recorded routinely?
- Failure to capture this data robs you of the chance to enhance your care delivery and your income.
- Reasons for the failure to record clinical data correctly are never insurmountable. They can be addressed in stages if required. The real question is how much does it cost you NOT to record this information?
- Addressing these questions will lead you to deliver improved care to your diabetic patients and improve your income from MBS rebates, PIP and SIP payments, GP Management Plans and Team care arrangements.
See the presentation from the Kelvale Medical Group in WA for an in depth treatment of income potential. Dr Ted Collinson & Ms Maryke Stockbridge, Kelvale Medical Group, WA (W1) RRMA 1
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