AMA calls for patient enrolment in last-minute budget submission

Other funding recommendations for the primary care sector include an extended attendance item and rural infrastructure grants.

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At T-minus five days, the AMA has finally revealed its primary care budget wish list.

Here’s what it asked for and how its requests differ from the other medical organisations.

The AMA’s big-ticket item was a voluntary patient enrolment (VPE) program, as described in the consultation draft version of the government’s Primary Health Care 10 Year Plan.

That draft version is still, of course, the only version of the plan in existence.

Last week, the AMA claimed it had been privately told by the Department of Health that there was no money in this budget to fund the plan, and as a result it would not be implemented.

The DoH, meanwhile, told The Medical Republic that the final version of the 10-year plan would, in fact, be released next Tuesday in the context of the budget.

VPE, in the form outlined in the draft 10-year plan, basically requires patients who want to access certain services, like MBS-funded telehealth or chronic disease management, to nominate a regular GP.

Perhaps in order to skirt around the no-money-for-primary-care issue, the AMA argues that implementing VPE will create $224.7 million in savings over four years, assuming a 75% uptake of services.

“Modelling indicates that linking chronic disease management and health assessment MBS items to VPE will result in a 4% reduction in claiming of these items (as these items will only be able to be claimed for enrolled patients, preventing potential misuse of these items),” the AMA said.

“Linking medication management review MBS items to VPE are expected to reduce claiming by 10%.”

These savings, the medical association argued, should be reinvested into a wound care program.

The AMA was the only organisation to outright recommend VPE in its budget submission, although the RACGP has been supportive of the measure in the past.

Interestingly, while the RACGP’s pre-budget submission does not mention VPE at all, it does recommend new service incentive payments that support continuation of care with patients from certain at-risk groups.

It appears that the AMA and RACGP have backed separate mechanisms to support the same outcomes.

Similarly, where the royal college asked for increased level C and D rebates as well as the introduction of a level E consult, the AMA wanted an extended level B item of $54.66  for consults between 15 and 19 minutes.

“Implementing an ‘extended’ Level B attendance item, linked to VPE, for consultations between 15 and 19 minutes will require a $1.03 billion investment from government over the four year forward estimates,” the AMA said.

In contrast, the RACGP’s proposal costs about $515 million over four years.

Other recommendations included aligning the definition of after-hours GP care with that of Approved Medical Deputising Services and increased payments for GP services in residential aged care facilities.

It also recommended a rural general practice grant program, where grants that are awarded are not assessable as income for recipients.

The federal budget will be released on the night of Tuesday 29 March.