Thursday, November 19, 2015

Medicare Benefits Schedule Review Consultation :President Report Dr Sue Andrews

On 26 October I attended a Consumer Workshop in Sydney, one of several convened by the Consumers’ Health Forum as part of the government’s consultation process for the Review of the Medicare Benefits Schedule (MBS).

The workshop was attended by a diverse range of consumer advocates and organisations including Breast Cancer Network Australia, Pain Australia, and the Australian Patients Association

The Minister for Health, Sussan Ley, gave some introductory comments about why the MBS needs to be reviewed and why consumer and carer input is critical to that process.
Professor Bruce Robinson, Chair of the Review Taskforce, then gave an overview of the Review, key issues in the Consultation Paper which is providing the basis for their call for public submissions.

Professor Robinson also provided an update on progress with the Review. Its first report to Government is due in December 2015.

MBS review activities have been distributed among several groups including Clinical Committees, a Principles and Rules committee and Item-specific working groups.
Of the 30 Clinical Committees, 6 priority areas were launched in October – Obstetrics, ENT, Gastroenterology, Thoracic Surgery, Pathology and Diagnostic Imaging.

The input received so far draws on a wide variety of experiences with the MBS:

  •  250 people have submitted feedback online, representing all states and territories.
  •  126 clinicians or health professional organisations, 96 consumers or carers, 20 others.
  •  Carried out a triage of items,
  • Created a preliminary list of obsolete items is being examined further,
  • Targeted areas are being moved into evaluation (eg sleep studies, pre-natal testing) and,
  •  Several new items have been proposed.
  • Referral regulation: Consumers and clinicians have asked to re-evaluate the three month limit on specialist to specialist referrals. This limit can force clinically unnecessary ‘renewal’ consultations.
  • Rural Delivery: As rural delivery models and workforce levels evolve, stakeholders have asked for updates to geographic adjustments such as exemptions and cost adjustments.
  • Ongoing item reviews: Stakeholders suggest that more frequent ongoing reviews could make the MBS a ‘living document’ improving the quality and relevance of procedures for patients.

The Review has already;

The Rules Committee is considering cross-cutting issues whose implications extend across the Clinical Committees including but not limited to;
Finally, there was some focused discussion around the key themes of the inquiry – unnecessary medical consultations, procedures or tests; application of Medicare rules; information requirements to make decisions about services; and how consumers could be engaged in the review process. 

The final discussion explored how consumers and carers could be better engaged in the Review process. The Review Taskforce have suggested consumers be involved as members of Clinical Committees, through public consultation on draft recommendations and through health consumer organisations. However they don’t have a clear consumer engagement strategy at this stage. Participants discussed other options such as social media and pointed out the importance of meaningful engagement with Aboriginal and/or Torres Strait Islander communities, Culturally and Linguistically Diverse communities, and refugee and migrant communities.

The MBS Review website contains all relevant information about the program, including outcomes of the consumer and stakeholder forums:

Dr Sue Andrews
President, HCCA

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