MBS-funded Services Project Plan

Brief prepared by:

Version:
Project Manager:
Approval Status:
Approved by:

(This planning template is provided to assist agencies in Grampians region who have
decided to enhance service delivery by using the MBS to fund additional services. Under
each heading there are some brief guiding notes, and where indicated there are additional
notes provided in the Appendices to this template.

This resource and other supporting resources are available at the Grampians MBS Industry
Advisor Project website www.health.vic.gov.au/pch/gpp/mbs_grampians.htm ).

Project Name:
(Be careful when using acronyms, ensuring the name will make sense to all applicable
stakeholders)

Background/Context:
(Describe why the project is being conducted, including a justification for potential change.
You may wish to talk about factors such as
 What are your current clinical services offered, hours of service, and client
numbers?
 What are the demand pressures/waiting lists? Are there service gaps?
 Who are the clients you currently serve - % chronic and complex needs clients
and % of clients utilising CH services via referral from GPs as part of care plans?
 What kinds of services are GPs requesting for their clients?
 Where are clients accessing services (if you have multiple sites) and is their
capacity to expand or build extended services?
 Is there a need to improve care for clients with complex/chronic disease?
 Have you previously used the MBS to fund services and if so, what was learnt?

Objectives:
(An explanation of what the project is seeking to achieve. Objectives should be SMART -
specific, measurable, achievable, realistic and time limited. Use ‘action-oriented’ words
when listing objectives e.g. extend, improve, reduce, review, undertake, conduct.
Consider the following factors:
 Increasing service availability to meet patient demand;
 reducing waiting lists by x% for a certain discipline or disciplines and in a certain priority
category (to see which disciplines are eligible to attract MBS-funded services, see fact
sheet “Provider disciplines that attract Medicare rebates (fact sheet) at
http://www.health.vic.gov.au/pch/gpp/mbs_grampians.htm );
 increasing provider EFT by x% for a certain discipline or disciplines to aid recruitment
and/or retention;

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  providing a new kind of service, clearly defined;
 improving service coordination and/or integrated chronic disease management by
working more collaboratively with private providers including GPs and others in general
practices such as nurses eg: by promoting and/or responding to all requests to
participate in Team Care Arrangements
 improving the achievement of objectives under another project, such as a quality
improvement, demand management or e-referral project)

Scope:
(What is within the scope of this project and what is excluded? Consider: which provider
disciplines will be or may be involved; which general practices/GPs you will be working
with; which towns or service sites will you deliver the services from; which staff will be
involved and who won’t be involved; what staff may be sensitive about and whether those
sensitivities will be touched on during the project. It is suggested that agencies be very
specific regarding scope and that the less experience you have in using the MBS, the
smaller the scope of the project should be)

Project and service system linkages:

(Will your project link with and/or build on other projects in the organisation? How? What
will be the impact on your current service system models of care? Have you considered
partnering with other agencies in developing a model?)

Project governance:

(Describe or develop a diagram for the project governance structure - who reports to who
on what? Who or what body makes decisions or has the authority to endorse or approve
over the life of the project? If a reference group or steering committee is established,
consider suggesting draft terms of reference. Consider a project manager, and project
officer. Consider involving the finance team regarding MBS billing and monitoring financial
viability, HR regarding recruitment/retention and employment arrangements, clinical
governance team/s, legal advice regarding the MBS model chosen, and the administration
team regarding appointments and billing processes)

Service model/s:

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(There are four key factors that must be considered when planning a service model that
attracts MBS benefits:

 location of service;

 provider recruitment – internal or external;

 MBS revenue flow – to provider or to agency; and

 management of the provider and billing – provider or agency.

Once these decisions are made, the service model type will be much clearer. Examples of
models include: extending the hours of salaried practitioners; ‘rooms for rent’; private
provider percentage split; and facilitation of externally provided MBS-funded services. An
agency may be interested in implementing more than one model eg: a salaried podiatry
model, and a percentage split physiotherapy model. More information is provided in
Appendix 1).

Service model 1

Factor Approach

(From within the agency, or external to the agency eg: in a

Location
general practice? From which site/s or department/s?)

(Recruiting existing staff to extend hours? Recruiting external

Provider recruitment
private providers? Recruiting contractors? Which disciplines and
whom, if known?)

(Will the provider direct 100% of MBS revenue to the agency and
MBS revenue flow
be remunerated through salaried arrangements? Will the
provider keep the MBS revenue and donate a % back to the
agency? Will the provider keep the MBS revenue and pay a room
rental fee?)

(Who will be responsible for billing Medicare – the provider or the

Management of the
agency? If it is the agency, whom specifically will be
provider and billing
responsible? Who is responsible for managing files, clinical
quality, and appointments – the provider, the agency, or both in
partnership and how will this work?)

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 Service model 2 (if applicable)

(Delete if not applicable, or replicate further if there are more than 2 service models planned)

Factor Approach

(From within the agency, or external to the agency eg: in a

Location
general practice? From which site/s or department/s?)

(Recruiting existing staff to extend hours? Recruiting external

Provider recruitment
private providers? Recruiting contractors? Which disciplines and
whom, if known?)

(Will the provider direct 100% of MBS revenue to the agency and
MBS revenue flow
be remunerated through salaried arrangements? Will the
provider keep the MBS revenue and donate a % back to the
agency? Will the provider keep the MBS revenue and pay a room
rental fee?)

(Who will be responsible for billing Medicare – the provider or the

Management of the
agency? If it is the agency, whom specifically will be
provider and billing
responsible? Who is responsible for managing files, clinical
quality, and appointments – the provider, the agency, or both in
partnership and how will this work?)

Risks Analysis:

(What are the risks and how will these risks be managed? Consider: financial viability
associated with throughput and length of MBS-funded consultations; HR, legal and
administrative risks; perceptions of the project and any associated reputational risks;
quality risks; and relationship risks.

With regard to each risk, consider

 Which specific factors or events could impact on your ability to deliver the project
outcomes?
 What is the potential impact of these risks?
 What are the consequences of these factors/events for the project?
 What is the likelihood of these risks occurring?

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  What specific actions will be taken to control, influence, manage or mitigate the
identified risks? Who will be responsible for this?

The following risk rating table and risk mitigation plan template may assist)

Consequences
Likelihood Insignifican
Minor Moderate Major Catastrophic
t
2 3 4 5
1
A
( almost certain ) M H H E E
B
( likely ) M M H H E
C
( possible ) L M M H E
D
( unlikely ) L M M M H
E
( rare ) L L M M M

E Extreme risk - detailed action/plan required with senior management attention

Level of H High risk - needs senior management attention

Risk: M Moderate risk - specify management responsibility

G
L Low risk - manage by routine procedures

Description G
Impact Conse- Likeli- Level of Risk Mitigation
of Risk quence hood Risk Approach
Rating Rating Rating

Stakeholders and consultation plan:

(Consider the need to liaise with or involve internal and external stakeholders - those
individuals or agencies who either need to be engaged in the project directly or who may
be impacted by the project or the outcomes of the project)

Communication Strategy:

(How will people be kept informed of the project progress and outcomes? Who needs to
know what, when, for what purpose? How will you report on the project?)

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Key tasks and timelines:

(Outline the key tasks to be undertaken to implement the project – consultation,

research, establishment, development, implementation, reporting, acting on
feedback and any emerging problems/risks, review. Consider:

 Education and training to understand Medicare items, processes and billing

 Ensuring processes to gain and maintain board support and managerial

support

 Establishing governance arrangements

 Analysing client data against client need to identify service gaps

 Analysing potential service models

 Seeking input and endorsement from general practice who need to be

integral to the model - including GPs, practice nurses, practice managers

 HR issues (recruitment, changes to existing staff contracts, insurance)

 Legal issues (including compliance with Health Insurance Act 1973 (Cw))

 Financial issues (ensuring MBS billing is linked to the provision of services,

and tracking financial viability of the model over time)

 Capital requirement issues (equipment, electronic billing systems, rooms)

 Clarifying expectations on providers who will be delivering additional

services: attendance at team meetings, clinical governance, record keeping,
OH&S, using facilities etc

Once these tasks are mapped, you may wish to develop a project Gantt chart to
link them with timelines – see Appendix 2)

Cost:

(Describe the overall cost of the project and relate this back to what is being purchased
i.e.: project justification)

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 APPENDIX 1
Additional notes: Service Model section
(drawn from the Department of Health document Client Services Through Medicare pages 9-10
www.health.vic.gov.au/pch/downloads/client_services_medicare.pdf )

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APPENDIX 1

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 APPENDIX 2
Gantt Chart

Project Name
Commencement Date
End Date

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Month/week
Activity
1
2
3
4
5
6
7
8
9
10