AMA and Australian Government reach agreement on future MBS changes

MedTech News: Following concerns raised by the Australian Medical Association (AMA) regarding the imminent Medicare rebate changes, The Australian Government and the AMA have now reached agreement to work together to co-design the administrative processes that support implementation of future changes to the Medicare Benefits Schedule (MBS) to ensure all parts of the system, including patients, are ready. 

This recognises that some changes are complex and require additional time to flow through systems to support high quality patient care and informed financial consent.

The MBS Review Taskforce has overseen the most comprehensive review of Medicare since it began, with the aim of modernising the system to ensure universal access to clinical best practice and supporting reinvestment of savings into new and amended items. 

The MBS Review Taskforce completed its activity on 30 June 2020, providing over 60 reports outlining almost 1,400 recommendations to the Australian Government on how to modernise the MBS, align it with contemporary clinical practice, and improve patient access and outcomes. 

The latest changes include updates to orthopaedic, cardiac and general surgery to better reflect modern practice, reduce low value care and incentivise advanced techniques with improved patient outcomes, for example new items for complex aortic procedures.

The MBS Review process which commenced in 2015 to review over 5,700 items, will now shift to a more business-as-usual footing, embedding a new continuous review into the ongoing management of the MBS schedule as recommended by the MBS Review Taskforce, led by Professor Bruce Robinson.

The Australian Government committed $17.3 million in this year’s Budget to implement this continuous review mechanism. This includes a new commitment to rapid post-implementation monitoring and review to ensure changes are delivering improved patient outcomes.

The Hon Greg Hunt MP, Minister for Health and Aged Care said “We will also continue to work to with the health insurance and hospital sector to implement improvements to administrative processes to allow time for all patients to have informed financial consent, including insurance rebates, before their procedures, while also monitoring the flow on effects of changes to health funds to ensure access remains affordable.

“We will continue to expand the Out of Pocket Costs website, which was first established in 2018, to further support patient choice and informed financial consent, including information about specialist medical fees and information about the private health insurance rebates that are available for procedures featured in the website.”

President of the Australian Medical Association, Omar Khorshid said “The AMA supports the MBS review process and welcomes the commitment by Government to work on process changes to the MBS review process to give additional time between public notice of the items and implementation.

“The goal of these changes is to ensure that while changing the MBS, we provide all the information a patient and a doctor need about Medicare and insurer rebates to provide informed financial consent.

“We will begin the co-design process after 1 July following implementation of the latest changes,” he added.