Women’s Health Week: check-in on new menopause MBS items

More than 20,000 women have undergone menopause health assessments since new Medicare Benefits Schedule (MBS) items began in July, but one expert says they fall short of bolstering access to care for women.
 
The new items were introduced by the Federal Government on 1 July as part of a landmark women’s health package designed to provide ‘better access, more choice and lower costs’ to patients.
 
GPs can now access item 695 for menopause and perimenopause health assessment services for patients experiencing premature ovarian insufficiency, early menopause, perimenopause and menopause.
 
Item 19000 is available to prescribing medical practitioners, described as those practising in general practice but not vocationally registered with either of the colleges.
  
The MBS item fee is $101.90 for GPs and $81.50 for prescribing medical practitioners, and it involves a minimum service duration of 20 minutes.
 
Australasian Menopause Society (AMS) past president and GP Dr Karen Magraith said the new items have prompted some GPs to upskill in menopause, or to pro-actively discuss menopause with patients, which is ‘a good thing’. 
 
However, she said increasing the Medicare rebate for longer consultations is a better overall approach to providing comprehensive care to women, especially to those who are disadvantaged.
 
‘We often need to have a detailed discussion of the risks and benefits of treatment options, and we need to give our patients the opportunity to ask questions,’ she told newsGP.
 
‘I certainly can’t do a comprehensive menopause consultation in 20 minutes. Mine are more likely to be 45-60 minutes.
 
‘Although I recognise that the menopause health assessment item may assist some GPs and patients, I would prefer not to see a specific Menopause item number… I would rather see higher Medicare rebates for longer consults.
 
‘It doesn’t really make sense to try to chop it up into menopause, mental health, or heart health. Just let us get on with providing patient-centred care to the person in front of us.’
 
But the Federal Government is positive about the success of its new items, saying it allows women to access the advice and support they need.
 
‘We’ve seen more than 20,000 women benefit from our perimenopause and menopause appointments with their GP where they’ve been able to access longer appointments, sometimes completely bulk billed,’ said Assistant Federal Health, Ageing and Women Minister Rebecca White.
 
The menopause assessment items were introduced alongside a raft of new measures, including the listing of several medicines on the Pharmaceutical Benefits Schemes (PBS) on 1 March.
 
Government figures released this week show 365,000 women have accessed more than 715,000 cheaper scripts for new oral contraceptives, menopausal hormone therapies and endometriosis treatment.
 
The PBS listing of three menopausal hormone therapies – estradiol (sold as Estrogel), progesterone (sold as Prometrium), and estradiol and progesterone (sold as Estrogel Pro) – has reduced the cost to women from as high as $670 a year to $31.60 per script or $7.70 if they are concessional, the Government explained.
 
Federal Health and Ageing Minister Mark Butler said the reforms are focused on making sure GPs are better equipped to support women going through perimenopause and menopause.
 
‘That included training and awareness, both for the general community, but particularly for primary care professionals like GPs, about how to best support their female patients as they are going through that part of life,’ he said.

Further moves to ‘strengthen Medicare for women’ will commence on 1 November, when changes to the MBS take effect to give women access to affordable IUDs and birth control implants.
 
But there is acknowledgement from the Government that more work lies ahead, including training more doctors, funding specialist clinics and tackling long-standing gender bias.
 
To genuinely bolster women’s access to healthcare, Dr Magraith said she would also like to see greater consistency of guidelines and resources for managing menopause, and improved women’s health education for GPs.
 
She also called for greater attention to the provision of appropriate care for menopause and other health issues for groups including Aboriginal and Torres Strait Islander women, women with diverse cultural backgrounds, disabled women, women in rural and remote areas and gender diverse people.
 
RACGP President Dr Michael Wright said the college will continue to work constructively with the Government and other women’s health organisations to help address ongoing health system issues and to reduce the gender care gap.
 
‘Improving women’s healthcare and addressing inequities in care and treatment must be the highest of priorities. We will keep working with government to make that happen.’

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MBS Medicare Medicare Benefits Schedule menopause perimenopause women’s health