MBS shake-up needed to support autism care

Better remuneration for longer consults is a must if patients are to have access to care, says the RACGP.

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The RACGP has provided input into the National Autism Strategy, which closed for submissions on 30 October, outlining the important role for GPs as the first port of call for autism care and the need for better remuneration.

A growing number of Australians are diagnosed with autism spectrum disorder each year – there was a 25% increase between 2015 and 2018.

In 2022, the federal government announced the development of the National Autism Strategy, which would cover “key reform areas including access to services, healthcare, education, and employment”.

In its submission to the strategy, the RACGP outlines the unique position of GPs to care for those on the autism spectrum, as they are able to act as the “anchor” to a multidisciplinary care team.

“GPs have unique knowledge of the patient family and community context as well as the patient’s co-morbidities, which are very common in autism,” the submission says.

“GPs are well placed to assess the needs and goals of care of individual patients with autism, and how best to progress towards those goals – including contributing towards the assessment and participation of their patients with autism in the National Disability Insurance Scheme (NDIS).”

According to the college, financial and systemic barriers to care must be removed to facilitate “accessible, inclusive and culturally safe care” – namely, poor Medicare support for coordinated care, which is especially important for those with complex needs, often including comorbidities.

“Coordination of the care of people with autism is necessary and should engage primary health, specialist providers, allied health, community health and community services,” the submission says.

“GPs can play a key role in that coordination of care as an integral part of a multidisciplinary team.”

The RACGP recommends that the MBS rebates, especially for longer consults, be increased “to reflect the real cost of providing ongoing comprehensive, patient-centred care”.

“In general practice, evidence clearly indicates longer consultations are linked to better health outcomes,” it adds.

The college also asks that remuneration be improved for administration associated with caring for patients with ASD, such as prepping documents for the NDIS, and for promotion of the current MBS health assessment items that may be useful for the care of those with autism.

Clear pathways for referral and improved information sharing between services will also be essential, it says.

The college also emphasises the importance of removing barriers to diagnosis services, especially for minority groups, and ensuring cultural safety measures are in place for Aboriginal and Torres Strait Islander people on the autism spectrum.

“Pathways to diagnosis can be facilitated through GPs where these pathways are clear and inclusive. It is especially important to support the family of the autistic child as well, especially where English is not their first language,” it says.

From diagnosis to ongoing care, care must remain affordable, and where Medicare cannot achieve this, other funding methods must be introduced.

Ultimately, the strategy must consider how people with ASD interact with the health system at every stage of life, ensuring support is ongoing and affordable.

“Attention needs to be paid to the whole life-course, and different requirements at different stages of life, which may include being diagnosed with autism spectrum in adulthood.”