MBS Reviews - AMA Warns that Massive Reforms Require More Detail
The AMA has lodged its submission to the Medicare Benefits Schedule (MBS) Review Specialist and Consultant Physician Consultation Clinical Committee (SCPCCC) report.
In the Submission, the AMA warns that the report is proposing massive change – time-tiered attendance items, in particular – but providing very little detail on implementation or impact on the range of specialists and their patients. In the end, the AMA could not support the recommendations in the absence of more detail and more consultation.
The AMA recognised early there was going to be a wide range of views, and that a change this significant would likely have a number of key, long-term, unintended consequences for the health system - a change that required significant, robust, and extensive stakeholder consultation with appropriate detail and information provided.
Following attendance at a poorly attended MBS Review Consultation in Canberra in March, the AMA undertook the following communications activity to encourage the entire profession to respond:
- the AMA President wrote to many medical specialty Colleges, Associations, and Societies to strongly urge them to provide feedback to the MBS Review Taskforce;
- the AMA President wrote in Australian Medicine magazine encouraging AMA members to respond directly to the MBS Review Taskforce;
- regular communications were published in the weekly AMA member newsletter, AMA Rounds;
- liaised directly with several Colleges and other organisations, as well as members and internal committees, to gauge support or opposition to key recommendations in the report; and
- lobbied the Health Minister’s office and the Department of Health to have the deadline for responses extended to the end of June (this was successful) for all the profession, to allow the communications to reach their audiences and to give people the chance to respond.
The AMA Submission is only a summary of the key issues, concerns, and feedback raised by the AMA’s members, Councillors, and other professional bodies.
If further consideration is going to be given with proceeding with some or all these recommendations, the AMA suggests that there should be a widely publicised Forum, with adequate lead time to discuss them with the whole profession.
This must be done before the MBS Taskforce considers them further, and it should include the necessary information that is missing from the report.
The AMA noted in its Submission that it is limited in being able to respond to the report more meaningfully due to these constraints.
In the absence of a compelling argument, backed with the data to allow modelling, the AMA disagrees with a number of the key recommendations outlined it the report.
In particular, the AMA is unable to support the proposed time-tiered attendance items given the significant concerns discussed in its submission, the unknown potential impact on specialist consultants broadly, and each of the various specialties more specifically – due in large part to the fact that no fees are proposed, nor any modelling provided.
Time-tiered consultations exist in general practice, and they already undervalue the work of GPs. Trying to model time-tiered items for non-GP specialists, based on this inadequate item structure, is a flawed approach that also ignores the obvious differences in practice models.
There was also strong opposition by AMA members to several other key aspects, including the proposed changes to telehealth items.
17 July 2019
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