COPD_Management_Programme_Sep_21_Final

COPD Management Programme – General Practice Service Delivery Service Description Patients with chronic obstructive pulmonary disease or congestive heart failure are funded for up to four consultations per annum, GPs can deliver the programme but it may also be nurse-led, following GOLD standard. The programme includes: 

Annual flu vaccination



Smoking cessation advice



Promotion of physical activity



Development of a CarePlan with the patient is mandatory



“Blue Card: Plan for People with Lung Conditions” is completed (this can be found on the PHO portal) and a screenshot is shown overleaf. Fridge magnets are available from the GPL team - please email GPSadmin@wboppho.org.nz to order.



Advice for patient self-management including early detection of symptom changes to reduce the risk of exacerbations requiring hospitalisation



Provision of additional follow up as required: -

Consider usage of CarePlus and High Need discretionary funding where available

-

If home visits are required, use WBOP PHO GP outreach – refer using Health and Wellness e-referral



1 enrolment only per patient will be funded across the WBOP PHO every 12 months



To continue to receive care under the COPD Management Programme eligible patients will need to be re-enrolled for a further 12 months



Currently no limit to the number of times an eligible patient may be re-enrolled



Further resources can be found in the PHO portal.

Eligibility criteria Provider Eligibility 1. All GPS can refer and any nurse providing COPD Management who has completed six hours WBOP PHO COPD education within the last 12 months excluding education provision sponsored by Pharmaceutical companies

Patient Eligibility 1. Patient is enrolled and funded with the WBOP PHO 2. Diagnosis of COPD confirmed by Spirometry 3. Priority Patients meet one or more of the following: -

Any High Needs patient or

-

Any patient holding a Community Services Card (CSC) or

-

Newly diagnosed COPD in the last twelve months or

-

Admitted to hospital in the last 12 months for COPD related issue

Claim process All PMS’s Claim using the Halcyon form, instructions on “How to Access Halcyon” from all Practice Management Systems are under H in this PHO Guide, or can be found on the PHO Portal: http://portal.wboppho.org.nz/funded-clinical-programmes/

  

Click on COPD Management Form New Claim under ‘Current Programmes’ or ‘Other Options’ tab.

The following tabs are mandatory to complete: Patient, Provider, and Clinical Details.

Screenshot of COPD Management Halcyon Form:

Checklist review checkbox is a mandatory field

Updated October 2021

Medtech, MyPractice and Profile practices An invoice will automatically be created in your PMS and a claim will be electronically sent to the PHO on completion of the Halcyon form. Please ensure practitioners "OK" the prompt box to generate the invoice and not just close it using the "X" at the top of the box.

Houston practices An invoice will need to be manually created in your PMS for internal reconciliation purposes. A claim will be electronically sent to the PHO on completion of the Halcyon form. Please ensure practitioners "OK" the prompt box to generate the invoice and not just close it using the "X" at the top of the box.

Payment There are 3 programme options to select from for claiming:

1. COPD Management and Pneumovax ($262.88 incl GST) 2. COPD Management only ($189.12 incl GST) Pneumococcal Vaccination - Pneumovax23 (23PPV – Sanofi) 3. Pneumovax only - this can only be claimed if COPD Management (only) has been previously claimed $73.76 incl GST Please Note: No patient co-payment is to be charged

Contact Details: Service Claims and Claim Queries can be sent directly to: PracticeClaims@wboppho.org.nz PracticeClaims@wboppho.org.nz is the singular email for sending PHO invoices/claims queries.

While the email is monitored, for faster delivery to the correct PHO Service, please add the name of the service in the subject line of the email.

For all other queries regarding Programme guidance and support, contact your General Practice Liaison directly, or the GPL Team at: GPSAdmin@wboppho.org.nz

Updated October 2021