General Practice in Aged Care Incentive

What is this incentive?

The General Practice in Aged Care Incentive (GPACI) commenced on 1 July 2024. It supports older people living in Residential Aged Care Homes (RACHs) to receive planned, quality primary care services from a regular general practice and general practitioner. The incentive replaces the PIP GP ACAI, which will cease on 31 July 2024. The new incentive was developed to address recommendations 56 and 61 from the Royal Commission into Aged Care Quality and Safety final report, with the intention of improving continuity of care and reducing avoidable hospitalisations.

Eligible providers and practices registered for MyMedicare who meet the servicing criteria will be able to receive quarterly incentive payments for providing regular visits and care planning to older people living in RACHs.

Key Benefits 

Eligible healthcare providers:

• will receive incentive payments for services provided to older people living in aged care
• benefit from rural loadings and rebates (Modified Monash Model areas MMM 4 to 7) for longer and more complex MBS items included in the GPACI servicing requirements
• may be eligible to receive the triple bulk billing incentive introduced in November 2023. The triple bulk billing incentive is available for each bulk-billed visit to a RACH resident
• receive incentive payments in addition to existing Medicare Benefits Scheme (MBS) and Department of Veterans’ Affairs (DVA) rebates.

Eligible general practices:

• will receive funding to support the delivery of quality care in aged care settings

Eligible RACH patients:

• will receive regular visits and care planning services from their responsible GP and practice
• will have improved continuity of care
• should experience reduced avoidable hospitalisations

Incentive Payments

If providers and practices meet the eligibility and servicing criteria, they can receive quarterly incentive payments. Providers receive payments for delivering care to their patients in RACHs, and practices receive payments for managing the administrative care for the patients:

• $300 per patient, per year, paid to the responsible provider
• $130 per patient, per year, paid to the general practice

Payments are made quarterly and are in addition to existing Medicare Benefits Scheme (MBS) and Department of Veterans’ Affairs (DVA) rebates. 

Latest Resources

• GPACI User Guide (MMM 1-3)
• GPACI User Guide (MMM 4-7)
• e-learning module: MyMedicare GPACI Payements and Correspondence
• GP and Practices Information Kit
• Care plan contribution template
• Patient front sheet template
• Patient monitoring and tracking tool
• GPACI Incentive Payment Structure
• General Practice in Aged Care Incentive fact sheet
• Frequently asked questions for GPs and practices
• Module about accessing and viewing eligibility and payments
• GPACI Program Guidelines

GPACI Incentive Payments Resources

Practices

• Search for and view payments forMyMedicare Incentives as a Practice
• Forecast eligibility for MyMedicare Incentives for an Organisation site/Practice
• Search for and view eligibility assessments for MyMedicare Incentives for an Organisation site/Provider
• Information kits for general practice
• Review of General Practice incentives consultation briefing paper

Providers

• Search for and view payments for MyMedicare Incentives as a Provider
• Infographic for providers to help access payment information through the Health Professional Online Services
• Forecast eligibility for MyMedicare Incentives as a Provider
• Search for and view eligibility assessments for MyMedicare Incentives as a Provider
  

Videos

• General Practice in Aged Care Overview webinar (RACGP)
• Information on registration
• MyMedicare and an overview of GPACI (short)
• Detailed video on GPACI (long)
• General Practice in Aged Care Incentive – Vodcast 1 – Enabling high quality primary care
• General Practice in Aged Care Incentive – Vodcast 2 – Enabling team-based care
• General Practice in Aged Care Incentive – Vodcast 3 – Variations in practice
• General Practice in Aged Care Incentive – Vodcast 4 – Facilitators and enablers

Eligibility

Registration for eligible practices, providers and patients is now open. 

Practices:

• must be an eligible and registered for MyMedicare in PRODA
• must be registered for the General Practice in Aged Care Incentive program
• need to link providers and patients to their practice and select the General Practice in Aged Care Incentive incentive indicator on each patient’s MyMedicare profile in PRODA

Providers must be:

• an eligible provider
• linked to an eligible practice
• declared as the responsible provider of eligible services to their registered patients

Patients:

• must permanently live in a RACH
• need to be registered with MyMedicare and linked to an eligible practice and provider

Participation

Incentive assessment periods

Delivery of eligible services commenced from 1 July 2024. The first incentive assessment period is from 1 July 2024 to 30 September 2024. If providers, practices and patients are registered for the GPACI before 30 September 2024, all eligible MBS and DVA items delivered during the assessment period will be used to calculate entitlement for incentive payments.

Assessment period servicing requirements

Practices and responsible providers must meet specific servicing requirements to be eligible for incentive payments.

Responsible providers must deliver two eligible care planning services over a 12-month period. In addition, responsible providers and their care teams must deliver two eligible regular visits per quarter, each in a separate calendar month, with a minimum of eight regular visits per 12-month period.

At least one of the eligible regular visits per quarter must be completed by the responsible provider. A second visit can be provided by the GP or another member of the patient’s care team, which includes:

• an alternate provider within the same practice
• a GP registrar
• a nurse practitioner
• an Aboriginal and Torres Strait Islander health practitioner or health worker

Assistance for GPs and general practices

Practices are encouraged to proactively sign up their patients living in RACHs. The MyMedicare PHN Implementation Program have created a suite of resources to help GPs and practices drive patient registration in RACHs, including:

• options for registration
• mail merge guide to pre-populate forms
• suggestions on how to engage with RACHs and their residents
• how to update HPOS to specify that the patient is a RACH patient
• additional resources

Please contact your Primary Care Engagement Officer or call us on 4708 8100 for more information about the above resources.

Eligible providers and practices registered for MyMedicare who meet the servicing criteria will be able to receive quarterly incentive payments for providing regular visits and care planning to older people living in RACHs.

Assistance for RACHs

It is important to be mindful of the timing of registering residents, as the process may take longer if a decision maker is required for consent.

Protecting Resident Privacy - It is important that your patient’s personal and health information is not shared without their permission. For this reason, please do not send us personal patient information, including names, dates of birth, health information or referrals. You can read more about the requirements for health service providers under the Privacy Act 1988 by visiting the Australian Government’s Office of the Australian Information Commissioner's Guide to health privacy.

For more information about how we can help your RACH, email the Healthy Ageing and Palliative Care team.

Find out more

For further information about GPACI, visit the Department of Health and Aged Care’s website or email the Healthy Ageing and Palliative Care team.