MBS – Item 699

The MBS (Medicare Benefits Schedule) item 699, also known as the Heart Health Check, is an initiative in Australia designed to encourage early detection and management of cardiovascular disease (CVD) risk factors. Introduced to reduce the burden of heart disease, this service allows general practitioners and other qualified health professionals to offer a comprehensive cardiovascular risk assessment and management plan for eligible patients. Here’s an overview of the key components of the MBS 699 Heart Health Check:

Eligibility

  • Patients: This check is available to all Medicare-eligible patients, especially those at higher risk of cardiovascular disease.
    • This includes older adults, people with existing risk factors (such as high blood pressure, cholesterol, diabetes, smoking), and those with a family history of heart disease.

Components of the Heart Health Check

  1. Risk Assessment: The check involves a detailed assessment of a patient’s cardiovascular risk factors. This includes collecting information on
    • medical history,
    • lifestyle factors,
    • family history, and
    • examination/investigation
      • blood pressure
      • cholesterol (ever 5 years for low risk, 1-2 years for high risk)
      • blood sugar level
  2. Risk Calculation: The collected data is used to calculate the patient’s risk of developing cardiovascular disease over the next five years using validated tools like the Framingham Heart Study or the Australian Absolute Cardiovascular Disease Risk Calculator.
  3. Management Plan: Based on the risk assessment, a tailored management plan is developed to address the identified risk factors. This plan may include:
    • Lifestyle modifications (such as diet and exercise recommendations)
      • Mediterranean diet
      • 5 x 30 minutes of moderate exercise per week
    • Pharmacotherapy (such as statins for high cholesterol or medications for blood pressure), and
    • Education on recognizing the symptoms of cardiovascular disease.
  4. Follow-up: Regular follow-ups and monitoring are recommended to evaluate the effectiveness of the management plan and to make adjustments as necessary.

Benefits of the Heart Health Check

  • Early Detection: Helps in the early detection of modifiable risk factors and the implementation of preventative strategies.
  • Prevention: Aims to reduce the incidence of heart attacks, strokes, and other cardiovascular events by managing risk factors effectively.
  • Cost-Effective: Covered by Medicare, making it financially accessible.

Implementation

  • Duration: The Heart Health Check is conducted over > 20-minute consultation.
  • Frequency: It is generally recommended that patients undergo this check annually.
  • MBS 715: This item can not be claimed in ATSI patients where a 715 has been claimed in the past 12 months.

The introduction of MBS item 699 reflects a shift towards preventive healthcare, recognizing the importance of early intervention in managing health conditions that are significant contributors to morbidity and mortality in Australia. It encourages a proactive approach to heart health, which is vital given the prevalence and impact of cardiovascular diseases.

The fact that it pays the same amount and has similar time/complexity requirements as item 36 makes its utility value to GP somewhat dubious.