By Rachel Clun
The most comprehensive review of the Medicare Benefits Schedule ever conducted found the system has failed to keep pace with advances in surgical techniques, medical discoveries and new treatments.
The finding comes from the final report from the MBS taskforce. The five-year review is the largest examination of Medicare since the system was introduced in 1984.
The taskforce said the growing complexities in health needs required an overhaul of public healthcare system funding. Credit: Virginia Star
The "fee-for-service" MBS model provided "inappropriate incentives" in some instances and can perpetuate inefficiency, the report said. While that model was still appropriate for some services, the taskforce said the public healthcare system needs to evolve as health needs continue to become more complex.
"Australians are now older, living longer, and with more complex and chronic health issues, and the fee-for-service approach of the MBS needs to adapt and evolve to meet those needs," the report said.
Items funded by the government through the MBS include things like consultations with doctors or specialists, tests including X-rays and MRI scans, eye tests, psychology sessions and some allied health services.
The report found there were barriers preventing "innovative approaches" from being used in the health system, including lack of data, the process for reviewing and introducing new technology and approaches to new models of treatment.
To help Australia keep pace, both with medical research and practice, the taskforce recommended the creation of a national institute for health research "to deliver system-wide change".
One of the taskforce's key recommendations was to shift away from reliance on the fee-for-service model and complement it with with blended or block payment models to support "more clinically appropriate" patient care.
"[This would] encourage more efficient, coordinated care with a greater focus on preventative health and better management of chronic conditions to deliver better outcomes for patients," the report said.
It also said the relative values of rebates should be reviewed. Aligning rebates to the length of patient contact would be "an appropriate and fair approach," the report said.
Royal Australian College of General Practitioners President Dr Karen Price said this was an "extremely important report" with many good recommendations and a few the college were a little concerned about.
"For mental health, the MBS review recommends longer consultations, we think that's good," she said.
Dr Price also agreed there needed to be other funding models to complement fee-for-service.
"We need to have contextually driven funded models, however that works, which is complex, that includes rural and remote practice, weighting for the complexity, and so forth," she said.
A wholesale reform of the MBS system was about ensuring the entire health system was efficient, Dr Price added, but reform should not come at the cost of funding for the work of general practitioners.
In its five-year review of the more than 5700 MBS items, the taskforce has produced more than 60 reports and made more than 1400 recommendations aimed at strengthening and modernising the public healthcare system. To date, the government has agreed to implement 520 of those recommendations.
In its final report, the taskforce said it had been consciously ambitious in its approach, seizing "this unique opportunity" to recommend changes that would modernise the system "at all levels".
A spokesman for Health Minister Greg Hunt said: "This is a report to government and not of government, and we will now consider, consult and respond as we have done throughout the course of the review in relation to all previous proposals."