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What do the MBS Taskforce recommendations mean for general practice?
Dr Michael Wright, Chair of RACGP Expert Committee – Funding and Health System Reform, talks to newsGP about the recommendations for general practice and the college’s response.
The RACGP wants to know what its members think about the MBS Review Taskforce recommendations for general practice.
The Medicare Benefits Schedule (MBS) Review Taskforce report from the General Practice and Primary Care Committee (the Committee), released just before Christmas last year, contained 18 recommendations for general practice.
Most of the recommendations amend current MBS items, but there are some fundamental changes, including a recommendation to introduce a fee for voluntary patient enrolment.
In order to help guide its response, the RACGP has already begun surveying its members on their thoughts about the recommended changes.
‘So far most members are supportive of the recommendations, but cautiously so,’ Dr Michael Wright, Chair of RACGP Expert Committee – Funding and Health System Reform (REC–FHSR), told newsGP.
Most of the report’s recommendations are focused around changes to the current MBS, which include:
- linking Medication Management Reviews to patients with General Practice Management Plans (GPMPs)
- expand the at-risk groups who are eligible for health assessments
- increasing the rebate for home visits for patients with GPMPs
- equalising the rebate for GPMPs and GPMP reviews
- introducing a new Level E consultation item number for consultations of over 60 minutes.
But it is another couple of recommendation in this vein that have so far caused the most concern among RACGP members.
‘These are the proposals to remove short health assessments and one to create a minimum six-minute time before a Level B consult can be billed to Medicare,’ Dr Wright said.
The report contains other broader recommendations related to primary care, most notably:
- move to a patient-centred primary care model supporting GP stewardship
- introduce a new voluntary patient enrolment fee
- introduce flexible access linked to voluntary patient enrolment.
‘These recommendations are more long-term, interlinked and likely to have the greatest impact on GPs, practices and our patients,’ Dr Wright said.
‘They mean that GPs will have a greater role in looking at patient care in the community – not just with each patient they are seeing, but in a population health role, as a patient advocate elsewhere in the system.
‘For example, when a patient needs care away from general practice, their GP might have the role of helping them get into hospital.
‘Flexible access is about recognising that the GP’s role is greater than just treating the patient sitting in front of them. We provide a lot of care that is not face-to-face, and this recommendation might recognise the value of that care.’
Dr Wright believes the second recommendation, introducing a voluntary enrolment fee, could help further encourage continuity of care without restricting access to primary care. But he also noted some caveats in terms of uncertainty about how this would be funded.
‘The report outlines its multiple recommendations, but does not provide advice or guidance on what fees for enrolment or providing additional care might be,’ he said. ‘This will be of central importance to understand whether providing this care is feasible for practices.’
The report is currently under consultation and the RACGP is seeking member feedback to inform its submission to the MBS Taskforce, which will be coordinated by the REC–FHSR.
Dr Wright suggests some key questions to help guide members when giving feedback.
‘Do you think this a better way to be paid and provide care for your patients?’ he said.
‘Is this the type of general practice that you want to be operating in? Does this sound like a better model of care for our patients and for us than the current system?
‘The answer could be either – we just want to know what people think about this.’
Members can visit the RACGP website to provide their feedback, or email advocacy@racgp.org.au, until 15 February.
general practice item numbers MBS Review Taskforce
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