Building a case for the Heart Health Check

• 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 absolute 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.

• 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