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RACGP sees room for improvement in changes to GP rebates in RACFs
Changes to MBS rebates for services provided in residential aged care facilities have come into effect, but the RACGP is calling for increased funding.
The RACGP is calling for increased funding for GPs providing services to patients in RACFs.
In the 2018–19 Mid-Year Economic and Fiscal Outlook (MYEFO), the Federal Government announced it would provide $98 million over four years towards Medicare Benefits Schedule (MBS) rebates for services provided by GPs attending residential aged care facilities (RACFs).
The current arrangements will change from 1 March.
The RACGP has been advocating for changes to the current structure, identifying the diminishing Medicare rebate per patient as a barrier for GPs supporting their patients in RACFs. The RACGP has also called for acknowledgement of the significant amount of unremunerated services provided by GPs for patients in RACFs.
The college has welcomed a new rebate structure that partly recognises the costs of attending an RACF for GPs; however, it is the RACGP’s understanding that the change results in a net reduction in funding if GPs are seeing 17 patients or more during a single RACF visit. The RACGP is seeking clarity on this issue. If correct, the change does not remove the barriers for GPs who provide services in larger RACFs.
‘Although the changes coming into effect are a good start, there is still a long way to go to adequately represent GPs providing services to RACF patients,’ RACGP President Dr Harry Nespolon told newsGP.
‘It does try to cover some of the non-consulting costs for GPs, such as paperwork and travel, so it’s a step in the right direction, but certainly nowhere near where it needs it to be.
‘It is improved but not fixed.’
Dr Nespolon acknowledges the position GPs are in when their patients are transitioned to RACFs.
‘We do want to see GPs working in RACFs and out of loyalty to their patients, but some may feel a great sense of loss due to their patients being moved to RACFs and unable to see them due to economic or geographic reasons,’ he said.
From 1 March, RACF items 20, 35, 43 and 51 will be replaced with new attendance items (90020, 90035, 90043, 90051), which will have a stable fee amount, as per attendances in consulting rooms.
MBS rebates for services provided in RACFs are currently calculated based on the number of patients that the GP sees – by dividing an integrated call-out fee by the number of patients seen.
This rebate structure results in patients receiving different rebates on different days, depending how many patients the GP sees.
As part of the change, the Government will introduce a one-off $55 Medicare payment to cover travel time and other additional costs for GPs attending RACFs (item number 90001). GPs currently receive $47.40 per visit to cover these costs, which is integrated into the base rebate – so the new payment represents an additional $7.60 per RACF visit.
The change separates the currently integrated flag fall fee from the base rebate, simplifying the rebate structure.
The RACGP supports the non-integrated flag fall fee, but will be calling for an increase to base rebates to provide appropriate support for GPs and their patients in RACFs.
The RACGP believes the funding change ultimately does not meet its intended purpose of providing further support to GPs providing care in RACFs, and this will be further exacerbated by the removal of the GP Aged Care Access Incentive, scheduled for 1 May as part of the changes to the Practice Incentives Program.
Dr Nespolon said the removal of the GP Aged Care Access Incentive is another concern.
‘This is contrary to supporting GPs – it seems to be giving with one hand and taking with the other,’ he said.
The RACGP will continue to call for increased funding for GPs and their patients in RACFs and will be undertaking advocacy in relation to this issue.
The new GP items for RACFs and their descriptors are available on the RACGP website and the Department of Health website.
aged care MBS items RACF residential aged care facilities
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