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What will the new financial year bring for general practice?


Morgan Liotta


30/06/2020 2:15:33 PM

Variations to indexation and telehealth items are among the key changes coming into effect from 1 July.

1 July calendar
MBS rebates will be indexed at 1.5%. from 1 July.

From 1 July 2020, Medicare Benefits Schedule (MBS) rebates will increase by 1.5%. With the Consumer Price Index (CPI) increase sitting at 2.2% at the end of the March 2020 quarter, this represents a lower increase in general inflation over 2019–20.

Following the Medicare freeze, a phased re-introduction of indexation was announced in the 2017–18 Federal Budget.

Findings from the 2019 General Practice: Health of the Nation report confirmed that Medicare rebates remain the top health policy issue for GPs, with the cost of providing care increasing year on year and not being matched through appropriate health funding.

The Productivity Commission’s Report on Government Services 2020 revealed that Government expenditure per capita on general practice decreased between 2017–18 and 2018–19.

The most commonly used MBS item in general practice – 23 (professional attendances at a consulting room for more than 20 minutes) – accounted for an average of 65% of all GP consultations between 2013–14 and 2018–19.
 
In 2013–14, the rebate for item 23 was $36.30, which increased to $37.05 in 2014–15 but was frozen at that level until 2018–19, when it was set at $37.60. The rebate subsequently increased to $38.20in 2019–20. This represents a 5.2% increase across those seven years.

The RACGP’s pre-budget submissions have consistently called for recognition of the true value of general practice services and a reduction in patient out-of-pocket costs that are increasing each year. The college recognised the increasing costs general practices face that are not covered by Medicare rebates – with the COVID-19 pandemic having a particular impact.

In its Vision for general practice and a sustainable healthcare system, the RACGP outlines the value of Australia’s primary healthcare system and the long-term return on investment of prioritising support for patient-centred care. It calls for appropriate and regular indexation against the CPI to ‘ensure the value of patient rebates maintain pace with inflation’, and identifies the rise in these costs each year outweighs the current indexation measure.

Further changes for the new financial year that will affect the general practice sector are outlined below.

Telehealth items for disaster-affected communities
On 1 November 2018, MBS items 2121, 2150 and 2196 for GPs and MBS items 894, 896 and 898 for non-specialist medical practitioners were introduced to provide temporary mental health services via telehealth to support patients in drought-affected areas until 30 June 2020.

These items were expanded on 10 January 2020 to support patients affected by the 2019–20 summer bushfires. Patients in drought-affected areas will no longer have access to these items from 1 July, but will continue to have access to mental health services provided by GPs and other healthcare practitioners via face-to-face consultations.

Telehealth support for patients considered to have had their mental health adversely affected by a bushfire that occurred in the 2019–20 financial year will continue into the new financial year. These items were indexed by 1.5%, in line with standard Medicare indexation.

National Immunisation Program
Changes to the National Immunisation Program (NIP) to improve protection against meningococcal and pneumococcal disease will be implemented following recommendations from the Australian Technical Advisory Group on Immunisation (ATAGI) and other clinical experts.

The meningococcal B vaccine will be added to the NIP for Aboriginal and Torres Strait Islander infants at two, four and 12 months of age, with an additional dose at six months for those with specified medical conditions. 

Introduction of the vaccine will be supported by a catch-up program for all Aboriginal and Torres Strait Islander children aged under two years until 30 June 2023.

Meningococcal B and meningococcal ACWY vaccines will also be funded under the NIP for people of all ages with specified medical conditions that increase their risk of meningococcal disease.
 
The RACGP’s 6 July webinar on the NIP changes will provide further information for GPs.
 
The seventh Community Pharmacy Agreement is also commencing from 1 July.
 
The voluntary patient enrolment (VPE) initiative was due to start with the new financial year, but the Department of Health recently announced a delayed introduction.
 
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Dr Pradeep Samarakoon   1/07/2020 6:15:53 PM

"The RACGP’s pre-budget submissions have consistently called for recognition of the true value of general practice services and a reduction in patient out-of-pocket costs that are increasing each year".
The government knows that the percentage of bulk billed consultations have in fact gone up over the years. Overall, reduction of patient out of pocket cost is not an issue for the government. In the current competitive business environment quality of GP service have to be maintained if a business is to survive. It is GP income that is directly affected. With corporate GP practices dominating the scene General Practice is becoming another "cost efficient" production line- if this is what the government wants. Majority of doctors in these corporate practices are international medical graduates(IMGs), supplying "cheap labour", bound to them because of 19AA, 19AB restrictions. Let's be honest and say we are concerned about drop in GP income. Also, RACGP lack a strong voice for IMGs.