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For professionals: Heart Health Checks

Heart Health Checks have been supported by Medicare since April 2019.

What is a Heart Health Check? 

A Heart Health Check is the patient-friendly term for comprehensive cardiovascular disease (CVD) risk assessment and ongoing management.  

The 20-minute check includes: 
  • Gathering information about a patient’s CVD risk factors 
  • Calculating and recording their absolute CVD risk using a validated calculator 
  • Managing their risk as per the Absolute Risk Guidelines on an ongoing basis. 
 
The delivery of Heart Health Checks in primary care is now supported by Medicare. On April 1st 2019, two items were introduced onto the Medicare Benefits Schedule (MBS): Items 699 and 177. Eligible patients can now receive a Medicare rebate when they get a Heart Health Check from a GP (Item 699) or other healthcare professionals (Item 177) working in primary care.  

These MBS items support the specific assessment and management of absolute CVD risk in primary care for eligible patients 45 years and over (30 years and over for Aboriginal and Torres Strait Islander patients).

Modelling over the next 5 years has indicated that up to 76,500 CVD related events (including heart attacks, strokes and deaths) could be prevented with the uptake of Heart Health Checks over the next five years. 

Heart Health Check Overview

All adults who are aged 45 years and above (30 years and above for Aboriginal and Torres Strait Islander peoples) and are not already known to have CVD are eligible for an annual Heart Health Check.

The Medicare items can be claimed once per patient per 12-month period. 

The absolute CVD risk for each patient must be calculated and recorded as per the online Australian CVD risk calculator or via calculators embedded in GP clinical software.  
A Heart Health Check is a 20-minute consultation by a GP or medical practitioner that includes:  
  1. Collection of patient information to identify CVD risk factors, such as diabetes status, alcohol intake, smoking status, cholesterol status and family history 
  2. A physical examination, which must include the recording of a blood pressure reading  
  3. Initiating interventions and referrals to address modifiable risk factors. This may include initiating blood pressure and cholesterol lowering medication for high risk patients where appropriate 
  4. Implementing a management plan for ongoing assessment and management of CVD risk  
  5. Providing the patient with preventative health care advice and information, including advice on modifying lifestyle risk factors.  
Visit MBS online for full details on the Heart Health Check item description, explanatory notes and schedule fees. 

Identify eligible patients  

  • Search patient records to generate a list of patients eligible for a Heart Health Check 
  • Opportunistically identify patients attending the practice 
  • Display Heart Health Check or Heart Age Calculator posters in waiting room to encourage patients to discuss during consultations 
  • Add Heart Health Check to online booking platforms and brief reception staff about what is involved.  

Recall eligible patients  

  • Use reminder letters, phone calls, text messages to actively recall patients eligible for a Heart Health Check
  • Set up clinical software flags so that eligible patients can be reviewed next time they attend the practice 
  • Consider attaching these checks to other preventative or chronic disease related visits.  

Conduct Heart Health Checks  

  • Collect risk factor information and examine the patient. Like any other health assessment, practice nurses or Aboriginal and Torres Strait Islander health workers may assist GPs in collecting this information 
  • Assess absolute CVD risk using calculator 
  • Develop relevant management plan which may include referrals, medicines and counselling. 

Set reminders  

  • Set regular reminders and recall patients annually where appropriate  
The underuse of absolute CVD risk calculators and lack of regular assessment has contributed to the under-treatment of high-risk patients. Existing Health Assessment items (701, 703, 705, 707& 715) aren’t specific to absolute CVD risk assessment, and importantly, some do not facilitate regular checkups and exclude priority age groups (50-74 years).  

The new Heart Health Check items help general practices prioritise the assessment and management of people at risk of CVD by setting up systematic processes to actively review patients and manage their CVD risk before they develop the disease.

Additionally, having a dedicated MBS item for CVD risk assessment means that data can be tracked on a national level and can drive quality improvement accordingly.   

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