Government’s prolonged silence on changes to chronic disease funding

Pharma News: The Federal Government’s decision to delay reforms to chronic disease management funding for general practice has been met with relief by the Royal Australian College of General Practitioners (RACGP), as it spares Australians from facing higher out-of-pocket costs for critical healthcare.

Originally scheduled to take effect on 1 November, the changes to Medicare items for Chronic Disease Management (CDM) have now been postponed to 1 July 2025. This extension follows significant concerns from healthcare professionals about the impact of the reforms on both patients and general practitioners.

According to data from the National Health Survey, one in two Australians is living with a chronic condition, and currently, 99.2% of CDM and complex care management items are bulk billed by GPs.

Highlighting the gravity of the issue, RACGP President Dr Nicole Higgins emphasised, “Australia is facing an epidemic of chronic illness, affecting more than half the population and contributing significantly to disability and premature mortality. Affordable healthcare access is pivotal for these patients.”

A newsGP poll reflecting the concerns of 1,367 RACGP members showed that 69% would struggle to continue bulk-billing chronic disease patients should current funding models be altered.

The reform, initially announced in last year’s May Budget, aims to consolidate the current GP Management Plan and Team Care Arrangements into a single GP Chronic Condition Management Plan. However, more than a year later, the government has yet to provide clear guidance on how GPs will be able to bill their patients under the new system.

Adding to the chorus of concern, the Australian GP Alliance (AGPA), which represents doctor-owned general practices, voiced its “profound concern and frustration” over the lack of communication regarding the changes.

“The lack of timely communication and certainty is not only imprudent but also detrimental to the healthcare system and the patients we serve,” the organisation said.

Dr Higgins further stressed, “There is no substitute for the quality care you get from a GP who knows you, and your history, particularly when it comes to chronic disease management. It’s what helps patients live healthier and longer lives and stay out of hospital.”

The AGPA stressed the broader implications, noting, “The health and well-being of millions of Australians depend on the stability and adequacy of funding for chronic disease management. We urge the government to engage in meaningful consultation with healthcare providers and stakeholders to ensure that any changes to the MBS support, rather than hinder, the delivery of high-quality, patient-centred care.”

“I look forward to working with the Government to ensure that there is enough funding for Australian’s living with chronic illness to get the care they need from their GP,” Dr Higgins stated.

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