After-hours care not value for money

Paul Hayes

24/10/2017 12:00:00 AM

The current structure of after-hours healthcare provision in Australia ‘supports the provision of comparatively low-value medical care and does not represent value for money for the taxpayer’, the Medicare Benefits Schedule (MBS) Review Taskforce has found in its final report.

The MBS Review Taskforce reports its findings on after-hours care
The MBS Review Taskforce reports its findings on after-hours care

The report, which reviewed the more lucrative urgent after-hours services MBS items (597, 598, 599 and 600), concluded that:

  • MBS funding should continue to be available for home visits, including in the after-hours period. Funding should continue to be available for after-hours services provided by a patient’s GP, as well as by a MDS (medical deputising service)
  • the rebates for urgent after-hours services should only be payable in circumstances where a GP who normally works during the day is recalled to work for management of a patient who needs, in the opinion of the GP, urgent assessment. The higher rebate recognises the additional clinical value provided by, and lifestyle and financial imposts on, GPs who deliver these services to their own patients, the practice’s patients or patients of other local practices where on-call work is shared
  • where a business has been established specifically to routinely or exclusively provide care in the after-hours period (including an MDS) then all of the other (non-urgent) items for after-hour services should remain available to these entities
  • the MBS items for urgent after-hours attendances should not be available where the patient has made an appointment prior to the commencement of the after-hours period (that is, 6.00 pm on weeknights).
The Taskforce has recommended changes to the descriptors and explanatory notes for urgent items to help create a clearer understanding of what constitutes ‘urgent care’.
The RACGP, which has long held concerns about the state of after-hours care and made submissions to the MBS Review Taskforce, has applauded the findings as a positive first step in a larger process.
‘We welcome the review and report, but more needs to be done to ensure patients always receive high-quality care when visited by after-hours home doctor,’ RACGP President Dr Bastian Seidel told newsGP.

after-hours MBS-Review Patient


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