Chronic Disease Management Plans & Physiotherapy – What are they and how do they work?

A Chronic Disease Management Plan (formerly called an Enhanced Primary Care or EPC) is a service that allows patients with chronic or terminal medical conditions to access Allied Health services through a GP’s referral.

This Government incentive for individuals with terminal conditions will allow any patient with a chronic condition to receive Medicare rebates for allied health services like physiotherapy and exercise physiology if deemed required by a GP.

Through this management plan, patients can receive team-based care from a GP or a group of health care providers generally involving a team of doctors, specialists and allied health practitioners.

Why do we need a Chronic Disease Management Plan?

Chronic Disease Management Plan can provide referral to 5 physiotherapy sessions at STRIVE physiotherapy in Townsville

Chronic diseases including diabetes, cardiovascular diseases and respiratory ailments impose a heavy burden on our health systems and the cost of addressing these chronic issues will only rise in the coming years.

Chronic diseases account for the largest share of deaths almost across the globe. In fact, in Australia, nearly 9 out of 10 deaths were due to chronic disease.

To mitigate these issues and provide a more structured approach to manage patients with chronic conditions, a Chronic Disease Management (CDM) plan enables your GP to plan and coordinate your health care.

You need to discuss your eligibility with your GP prior to obtaining a CDM plan.

How is a Chronic Disease Management Plan effective in Physiotherapy?

A CDM plan provides a platform for assisting both patients and physiotherapist’s in managing chronic illness by identifying a patient’s medical needs and planning for the best treatment available.

The role of a physiotherapist is important in managing chronic diseases. They practice and implement therapy exercises to safely optimise a patient’s day-to-day physical activities.

A CDM Plan provides the physiotherapist a platform to:

  • Manage the care of patients at various levels of chronic diseases.
  • Manage chronic lung diseases including Asthma through exercise prescription and cardio-respiratory rehabilitation at our clinic.
  • Assists patients to safely and effectively self manage their conditions at home.

Benefits of Chronic Disease Management Plan for patients and Allied health professionals

  • Improved health care services and outcomes for patients.
  • Reduces the knowledge gap between patients and how to manage their chronic conditions.
  • Reduction in hospitalisation, therefore by preventing hospital admissions money is saved.
  • Provides a platform for patients to access allied health services.

How it works: Medicare rebates for physiotherapy

Through CDM Plan, up to 5 physiotherapy visits are covered each year, Physiotherapy in Townsville

Through Medicare, eligible patients can access up to 5 yearly sessions of physiotherapy or any other allied health service. This is available for patients whose GP has initiated a CDM plan through Medicare.

However, if there is a requirement of further physiotherapy intervention, people often seek a private practice physiotherapist and may use their private medical cover for their treatment.

You will need to consult a GP who will determine if a CDM Plan is beneficial for you. Here are the steps to avail medicare rebates for physiotherapy.

Step 1 – Your doctor will conduct an early assessment that can include a blood test and a quick physical examination to determine if your disease is deemed chronic. A disease including complex musculoskeletal condition is considered a chronic condition if you have been suffering for at least 6 months or the condition is likely to last for greater than 6 months.

An eligible condition also means that two or more health care providers (GPs, specialists, allied health practitioners) will be involved in managing it.

Step 2 – Your GP will then decide on your eligibility and approve it according to the Department of Health’s Chronic Disease Management Eligibility Items. They will also complete all the necessary paperwork and prepare a CDM plan for you.

Step 3 – Once a CDM Plan is placed, you can attend any physiotherapists like STRIVE Physiotherapy and avail your entitled 5 Allied Health service sessions per year. This can be either 5 physiotherapist sessions or a combination of other services.

Patients are required to renew their CDM Plan referral after every 12 months. The eligibility of a renewal of a CDM Plan will be essentially determined by your GP.

A CDM Plan can also be granted under special consideration where there has been significant changes in the patient’s condition which is again determined only by a GP.

What to expect at STRIVE Physiotherapy?

Once you have visited a GP and are eligible, you must be referred to our Townsville physiotherapy clinic through a referral form.

After your paperwork is completed, do an online appointment at our Physiotherapy clinic in Townsville to start your treatment. You need to bring along your referral and other medical documents.

As part of your management plan, our physiotherapist will be in constant correspondence with your GP.

It is recommended to use your Medicare entitlements first and then your private health rebates if you have.

If you have any questions about your CDM plan and our services, call us at (07) 4773 6133 for further discussions.

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