General Practice in Aged Care Incentive

What is this incentive?

The General Practice in Aged Care Incentive (GP-ACI), which commences from 1 July 2024, will support 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 will replace the current PIP GP ACAI, which will cease on 31 July 2024. The new incentive has been developed to address the Royal Commission into Aged Care Quality and Safety Recommendations 56 and 61, 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.

What are the key benefits of the GP-ACI? 

Eligible providers:

• will receive payments for services provided to older people living in aged care.
• benefit from rural loadings and rebates (MMM3-7) from longer and more complex MBS items included in the GP-ACI 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.
• incentive payments are made in addition to existing Medicare Benefits Scheme (MBS) and Department of Veterans’ Affairs (DVA) rebates.

Eligible practices:

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

How Payments Work

Providers and practices registered for MyMedicare can receive quarterly incentive payments if they meet the eligibility and servicing criteria. Eligible providers receive payments for seeing their patients in RACHs, while eligible practices receive funding to manage care for these patients.

Payment Details:

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

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

Eligibility and Participation

Practices and providers can begin registering themselves and their patients for the GP-ACI now, and deliver eligible services from 1 July 2024. The first incentive assessment period is from July to September 2024. If practices and residents are registered for the GP-ACI before 30 September 2024, eligible MBS and DVA items delivered during that full assessment quarter (July 2024 to September 2024) will be used to calculate entitlements for incentive payments.

For Practices:

• Practices must be an eligible practice and registered for the MyMedicare program in PRODA.
• Practices must be registered for the General Practice in Aged Care Incentive program, which can be done through PRODA from 1 July, 2024.
• Practices need to link providers and patients to their practice and select the incentive indicator on each patient’s MyMedicare profile in PRODA.

For Providers:

• Providers must be linked to an eligible practice.
• The provider must be declared as the responsible provider of eligible services to their registered patients.
• Providers can participate in the program from 1 July, 2024.

For Patients:

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

Servicing Requirements

Providers and practices must meet specific servicing requirements to be eligible for incentive payments.

This includes delivering two eligible care planning services over a 12-month period. The care planning services include comprehensive medical assessments and multidisciplinary case conferences.

In addition, providers and their care teams must deliver at least two eligible regular visits per quarter, delivered in separate calendar months, with a minimum of eight regular visits per 12-month period. At least one of the eligible regular visits conducted per quarter must be completed by the responsible provider. A second visit can be provided by another member of the patient’s care team which includes:

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

Assistance for RACHs

We are assisting RACHs in the administration of patient registration. 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 some residents. 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 GP-ACI, visit the Department of Health and Aged Care’s website or email the Healthy Ageing and Palliative Care team.