21 January 2019

MBS Review: A stronger primary care system in sight?

Government MBS

Implementing healthcare reform in Australia is always an uphill battle. After a disappointing outcome of the much-anticipated Healthcare Homes program, some of the members of the Primary Health Care Advisory Group regrouped when they were appointed to the Medicare Benefits Schedule (MBS) Review Taskforce.

The recommendations by the taskforce to improve the MBS are refreshing in many ways. There is a move towards strengthening GP stewardship, voluntary patient enrolment, more non face-to-face care, a simpler careplan program and increased support for home visits – which seems sensible and is addressing the frustrations of many about the current Medicare system.

It appears there are a few things missing. For example, there is no recommendation to spend more time with our patients by committing to an increase in the schedule fee of longer consultations (item numbers 36 and 44). This would have been more useful for most patient encounters than a new one-hour plus item number.

I believe the residential aged-care item numbers will need more investment when the SIP incentive ceases to exist. There is mention of outcome-based payments which requires an explanation. The lack of detail about the dollar values makes it challenging to predict the impact on general practice and primary care.

In an ideal world, the recommendations could result in an invigorated, modern, patient-centred health system. However, if history repeats itself, the result will be a simple cost-saving exercise, dressed up as clinician-led, evidence-based healthcare reform.

A typical case of make it or break it.

This article first appeared on Doctor’s Bag and is republished with permission. Read the original blog here.

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4 Comments on "MBS Review: A stronger primary care system in sight?"

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David Dahm
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9 months 27 days ago

Get rid of Medicare and issue health vouchers based on a patients clinical profile. Operate it like the NDIS with profession led and enforced standards.

Instant patient care would arise because patients and not third parties would demand what they wanted and needed. This would save a lot of money and red tape.

Lou Lewis
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Lou Lewis
9 months 28 days ago
When I first read about the MBS review last year , my first impression was that it was going to be stacked with former presidents of the AMA and the RACGP and academics who claim to be GPs but who are very very part-time GPs, and by the looks of things, I wasn’t wrong. My other thought about the MBS review that it was going to further decimate general practice and unfortunately this seems to be the way it is going. There are too many things in the list but one that concerns me the most is the recommendation that… Read more »
Ralph Vida
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Ralph Vida
9 months 28 days ago
Peter is right. Of course the money is not there and ergo cannot be allocated, so will leave any findings requiring funding in limbo. Welcome to Emperor’s New Clothes, Incarnation MMXIX. “See the fine weave…” Ho hum. Refer to ANY Dr Menon article from 1980s Oz Doc back page for more erudite analyses /explanations… Onya Jodhi. Killing the “Kollege” and involving GPs in tertiary referral triaging with incentives and /or penalties for manipulation would be my starting point. Why no college? It’s simple. The Holy Grail that is evidence-based decision making bears no evidence that CPD makes anyone a better… Read more »
Peter Bradley
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Peter Bradley
9 months 28 days ago
“After a disappointing outcome of the much-anticipated Healthcare Homes program” That was disappointing ?- completely predictable I would have said. What about the nil outcome achieved after years and over a million dollars spent on the ‘Relative Values’ study. They didn’t like what it concluded, so shelved – literally. Right back then was the golden opportunity lost to give a real and meaningful boost to general practice. Then you say… “In an ideal world, the recommendations could result in an invigorated, modern, patient-centred health system. However, if history repeats itself, the result will be a simple cost-saving exercise, dressed up… Read more »
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