Building a case for the Heart Health Check

There are several differences between items 699/177 (the Heart Health Check) and other health assessment items:

• patients aged 50–74 are now eligible

• patients aged 45–74 can now be checked every 12 months.

Further differences in eligibility and claim frequency between the various items are outlined below.

Download a PDF of the table

• QI 1.1 – Quality improvement activities

• C4.1 – Health promotion and preventative care

• C7.1 – Content of patient records

• C8.1 – Education and training of non-clinical staff

• recruit team members with different skillsets to help develop ideas and support the implementation of Heart Health Checks

• address any knowledge or skills gaps relating to Heart Health Checks and CVD risk assessment and management guidelines

• ensure all team members understand the Medicare requirements that must be met before billing item number 699 or 177.

Current data is needed to define your baseline and measure subsequent success in completing Heart Health Checks.

The quality of your clinical data is important in ensuring you accurately target patients eligible for a Heart Health Check.

Identifying and addressing data gaps can help you to set goals to drive quality improvement activities.

TIP: The Heart Foundation has interactive Heart Maps that are scaled to region and local government area.

TIP: Your local Primary Health Network (PHN) representative can assist you with the types of clinical audit tools available (e.g. Pen CAT, POLAR) and their use.

• See the table below comparing the age range and billing timeframes of the Heart Health Check to other health assessment items (e.g. 701–715).

• Add routine yearly Heart Health Check reminders to eligible patient records and your practice registers.

• Incorporate other incentive programs to add value to your Heart Health Check activities e.g.

  • the Practice Incentive Program Quality Improvement (PIP QI) measures align with several components of the Heart Health Check. Refer to the QI incentives section

  • chronic disease management (CDM) items – for patients who have a chronic condition you can co-claim relevant CDM item numbers

  • consider if patients are also eligible for a medication management review

  • bulk billing items that can be used include 10990 or 10991 for eligible patients.

  • use the workforce incentive program (WIP) to increase the support services of your nurses, Aboriginal and Torres Strait Islander health workers, and eligible allied health professionals

  • seek out relevant locally designed lifestyle programs with your PHN, or via HealthPathways.

TIP: Map the workflow from patient recruitment to claiming and develop a flowchart to demonstrate financial viability.