Managing persistent health conditions (such as low back pain) effectively requires a comprehensive approach that involves coordinated care between healthcare providers and patients. Medicare offers a Chronic Disease Management (CDM) Plan to assist individuals with chronic conditions in accessing necessary healthcare services.
What is a Chronic Disease Management (CDM) Plan?
A Chronic Disease Management (CDM) Plan is a program initiated by Medicare Australia to support individuals with chronic medical conditions. The CDM Plan aims to improve health outcomes for patients by facilitating access to a range of healthcare services.
If your GP has identified that you have a chronic medical condition (for example, low back pain, diabetes, high blood pressure, asthma, cancer, heart disease, arthritis, or stroke) you may be able to access up to 5 sessions with allied healthcare providers under a CDM referral. Medicare provides a rebate of $58.30 per session (as of February 2024). To be eligible, you must have:
- A chronic medical condition which has been present for 6 or more months
- A condition that requires ongoing treatment from a multidisciplinary team, with at least 2 other medical or allied health practitioners involved in your care (in addition to your GP)
The Components of a CDM Plan:
- General Practitioner (GP) Management Plan: The GP develops a comprehensive management plan tailored to the patient’s specific health needs. This plan outlines treatment goals, interventions, and strategies for ongoing care.
- Team Care Arrangement (TCA): In collaboration with the GP, the patient may receive a Team Care Arrangement which involves coordinated care with other healthcare providers, such as specialists, nurses, and allied health professionals.
How can I use my Chronic Disease Management Plan at Connect Healthcare?
Connect Healthcare and its allied healthcare team welcomes CDM referrals as an effective way to help clients proactively manage any chronic health conditions.
To use your referral at your appointment, ask your GP clinic to send us a copy prior to your appointment, or you can bring in a hard copy with you on the day.
At the time of payment, we will require full payment for the service you received, and then we can process the Medicare rebate back onto your savings card or into your nominated bank account recorded with Medicare.
We understand that the CDM scheme was introduced to provide additional financial support through Medicare for people with chronic medical conditions, so we are proud to offer a reduced gap payment for all our clients with a valid government concession card. We charge a $50 gap for initial consults and a $10 gap for standard consults. Should you have a complex case that requires a longer appointment time (45 minutes or longer), we charge a $30 gap.
Benefits of Chronic Disease Management Plan Referrals:
- Coordinated Care: Referrals facilitate coordinated care among healthcare providers, ensuring that patients receive comprehensive and integrated healthcare services.
- Access to Specialised Care: Patients can access specialist medical care and allied health services that are essential for managing chronic conditions effectively.
- Improved Health Outcomes: By accessing timely and appropriate healthcare services, patients can better manage their chronic conditions, leading to improved health outcomes and quality of life.
Understanding Chronic Disease Management Plan Referrals:
Referrals are an integral part of the CDM Plan, enabling patients to access allied health care services beyond what their GP can provide alone. Here’s how referrals work within the framework of the CDM Plan:
- Allied Health Referrals: Patients may benefit from allied health services such as chiropractic, exercise physiology, physiotherapy, podiatry or dietetics to manage their chronic condition effectively. The GP can issue referrals for these services as part of the CDM Plan.
- Maximum Referral Limit: Under the CDM Plan, patients are entitled to a maximum of five allied health services per calendar year. Each referral covers a specific number of sessions, typically up to five, with an allied health professional.
- Referral Validity Period: Referrals issued as part of the CDM Plan are valid for up to 12 months from the date of issue. Patients can utilize these referrals within the validity period to access the recommended healthcare services.
If you have any questions please feel free to contact our friendly admin team on 08 8357 2348 or info@connecthealthcare.com.au