General Practice in Aged Care Incentive
What is the 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 Practice (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.
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GPACI Quarter 4 Service and Payment Requirements
The GPACI Quarter 4 (Q4) servicing and payment requirements are different from those in Q1, Q2 and Q3. Practices and providers who registered patients for GPACI between July and September 2024 should note that these patients are now in Q4 of their 12-month care period.
To receive incentive payments for GPACI patients in Q4, practices and providers must deliver the GPACI quarterly servicing requirements and the GPACI annual servicing requirements.
Quarterly requirement:
- Minimum of 2 regular services per patient in separate calendar months; at least one delivered by the Responsible Provider.
Annual requirement:
- 2 care planning services delivered by the Responsible Provider.
- 8 regular services delivered by an eligible provider linked to the same practice as the patient receiving the services.
Failure to meet the annual servicing requirements:
If the Responsible Provider does not deliver the 2 care planning services by the end of the 12-month care period:
- the practice and the Responsible Provider will not get the Q4 payment.
- the Responsible Provider must deliver at least 1 care planning service in Q1 of the following 12-month care period.
If the requirements are not met, the practice and provider will be ineligible for the Incentive payments for that patient for the remainder of the patient’s new 12-month care period.
Additional information regarding servicing requirements, including for Q4, can be found in the GPACI Guidelines.
Key Benefits of the General Practice in Aged Care Incentive
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.
Resources
GPACI Incentive Payments Resources
Practices
Providers
Videos
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, Disability and Ageing’s website or email the Healthy Ageing and Palliative Care team.
