AMA calls for ‘robust review’ of MBS, not cost-cutting

Medical politics

28 Oct 2015

The medical profession is being asked to commit significant time and effort to a large, but rapid, review of the MBS with little certainty that the final outcomes will support the holistic needs of patients, the AMA has said in its submission to the MBS Review Taskforce.

Citing a long history of contributions to earlier MBS reviews, the submission warns against a focus on cost-cutting.

“It is critical that this current review process is not prejudiced or compromised from the start by the comments made by the Minister for Health and the Chair of the MBS Review Taskforce,” it says.

Their comments included claims that 97% of MBS items have never been assessed to check they are clinically-effective, cost-efficient or safe, and that “30% or more of health expenditure is wasted on services, tests and procedures that provide no or negligible clinical benefit and in some cases…could actually cause harm to patients.”

“A review that leads to arbitrary cost-cutting, or diverts any savings from services to the budget bottom line, will not be supported,” the AMA says.

Continuing support of the review by the medical profession will require full confidence that the emphasis is on patient care, and that it will deliver a schedule reflecting modern medical practice and medical services that are provided today.

The AMA supports the role of clinical committees or working groups in setting the clinical questions, reviewing the evidence, testing their findings with the affected craft groups, and recommending appropriate changes.

This process will take longer than the mechanism proposed by the Taskforce, but will reduce the risk of fragmented changes to the MBS that don’t reflect modern practice.

“There is an overarching theme in the consultation paper that the MBS, and its fee for service approach, is the driver of too much, or inappropriate care, and therefore the MBS should be the vehicle to address that,” it says.

However, the MBS represents only 12.5% of total health expenditure and 30% of the total Commonwealth expenditure on health.

“Even if the MBS were to…restrict the payment of a benefit to the patient, it may only have the effect of reducing the Medicare outlay and shifting the cost elsewhere.”

Changes forced on the private sector would also mirrored in the public system.

“Patients will seek the clinically appropriate treatment in the public sector if it is not available to them in the private sector,” it says.

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