Chronic Disease Management

What is Chronic Disease?

Chronic diseases are prolonged conditions that often do not improve and are rarely cured completely. Diabetes, dementia, congestive heart failure and asthma are examples of chronic diseases. The increasing incidence of chronic disease is a challenge facing health services in Australia and around the world.

A ‘chronic medical condition’ is one that has been or is likely to be present for at least six months, including but not limited to asthma, cancer, cardiovascular disease, diabetes mellitus, musculoskeletal conditions and stroke.

What is Chronic Disease Management?

Chronic Disease Management (CDM) is a systematic, coordinated approach to improving health care for people with chronic disease across the healthcare system. The approach aims to improve the quality of life and health outcomes of those already diagnosed with one or more chronic diseases and reduce the progression and complications of their illness.

The Chronic Disease Management (CDM) Medicare items on the Medicare Benefits Schedule (MBS) enable GPs to plan and coordinate the health care of patients with chronic or terminal medical conditions, including patients with these conditions who require multidisciplinary, team-based care from a GP and at least two other health or care providers. The items are designed for patients who require a structured approach to their care.

Whether a patient is eligible for CDM services is a clinical judgement for the GP, taking into account the patient’s medical condition and care needs, as well as the general guidance set out in the MBS.