Health Care Homes what does it all mean

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Allied Health Services provided to Health Care Home-enrolled Patient
October 2017
About Health Care Homes

The Health Care Homes stage one trial has commenced in ten regions around Australia. A Health Care Home is an existing general practice or Aboriginal Community Controlled Health Service that will provide a ‘home base’ for the management of an eligible patient’s chronic conditions and delivers coordinated, team-based care around the needs and goals of the patient.
The Health Care Home will facilitate a partnership between the patient, their families and carers, their treating general practitioner and the extended health care team, allowing for better-targeted and effective coordination of clinical resources to meet patient needs.
The stage one trial commenced on 1 October 2017 and will conclude on 30 November 2019.
More information about Health Care Homes is available at http://www.health.gov.au/internet/main/publishing.nsf/Content/health-care-homes-information
Medicare Benefits Schedule-funded access to allied health services

Health Care Home-enrolled patients will have multiple chronic conditions and, as such, would have been eligible to access Medicare Benefits Schedule (MBS)-funded allied health services that are currently triggered by a GP Management Plan and Team Care Arrangement. They may also have been eligible to access MBS-funded allied health services that are currently triggered by a Health Assessment for Aboriginal and Torres Strait Islander People or a GP Mental Health Treatment Plan.
Eligibility to access MBS-funded allied health services previously triggered by the completion of these MBS items will now be triggered by the patient’s enrolment with the Health Care Home and preparation of a shared care plan. Health Care Home-enrolled patients no longer need to have a GP Management Plan and Team Care Arrangement or a Health Assessment for Aboriginal and Torres Strait Islander People or a GP Mental Health Treatment Plan to access MBS-funded allied health services.
It should be noted that other prerequisites as defined under the Health Insurance (Allied Health Services) Determination 2014 will continue to apply for enrolled patients to access allied health MBS benefits. These prerequisites include the need for a valid referral form or, where appropriate, Aboriginal or Torres Strait Islander descent status. Eligibility for allied health group sessions will also be triggered by enrolment for eligible patients with Type 2 diabetes.
The number of Medicare benefits for allied health services that an enrolled patient may access each calendar year remains the same as is currently available under the MBS. If an existing patient enrols as a Health Care Home patient, this does not restart the number of Medicare-funded allied health services available to that patient in a calendar year, i.e. if rebates are available for up to five allied health services in a calendar year and the patient has already received two services, the patient will have three services available for the remainder of the calendar year.
Allied health services provided to a Health Care Home-enrolled patient should be billed to the MBS in line with current arrangements.
Coordinating services

A central element of the Health Care Home model is a tailored and dynamic electronic shared care plan. A Health Care Home must ensure that all enrolled patients have a shared care plan and can access it. The aim of a shared care plan is to increase a patient’s participation in their own care and improve the coordination of the services that they received, both inside and outside the Health Care Home.
Health Care Homes will have flexibility in the format of a written referral and how it is provided to allied health providers. The referral information should also be reflected in the patient’s shared care plan. For a patient’s shared care plan to be used as the referral, it must contain all the components of the form issued by the Australian Government Department of Health, available at http://www.health.gov.au/mbsprimarycareitems.
In addition to a shared care plan, Health Care Home-enrolled patients will have a My Health Record and allied health service providers are encouraged to up-date the patient’s record with relevant and appropriate information.

https://www.legislation.gov.au/Details/F2013L02134