The Federal Government’s decision to cut Medicare funding for specialist phone consults is primarily a cost saving measure that will jeopardise patient access, the AMA says.
From July 1, specialists will be restricted to a single MBS item for any consult via phone, with a rebate of $38.60 covering only minor consults.
Phone items for initial and subsequent attendances, along with those for complex attendances (equivalent to MBS items 110, 116, 132 and 133) will be scrapped.
However, funding for MBS video consults will remain untouched for the time being.
Initially scheduled to commence in January, the cuts have been defended by the federal health department, which says they are “informed by Medicare data and expert advice, including the MBS Review Taskforce findings on telehealth”.
Published in 2020, the taskforce’s report said videoconferencing offered a “richer information transfer” compared to phone calls and that the “use of the telephone alone [for consults] should be the exception rather than the rule”.
But AMA vice president Dr Chris Moy said the profession had been blindsided by the government’s decision, which he said would ultimately harm patient care.
“There is nothing wrong with trying to encourage the use of video but the fact is that there are many people who struggle with the technology,” he said.
“It means that people who aren’t digitally savvy, especially the elderly, and people without good internet connections will miss out.”
“Those considerations should have been factored into the decision making, because to have a single blanket policy is seriously problematic.”
While there were clinical reasons why video should be encouraged, it was clear the government’s main motive was a financial one, Dr Moy said.
“If it was simply about higher quality care, they would have left it open for patients in rural areas for example,” he said.
“They also would have consulted with the medical profession before going ahead with the announcement.”
“Of course video is far better than just using telephone, but for some people it is just not an option. So why be callous and cut their service entirely?”
Medicare statistics showed the four physician telephone items had been claimed almost 5.6 million times since their creation in early 2020, costing taxpayers some $455 million in rebates.
By contrast, the video equivalents had been used just 1.1 million times over the same period.
Last week, Clinical Oncology Society of Australia president Professor Fran Boyle called on both major parties to make keeping the items a federal election commitment.
“We’ll be wasting an advancement which was one of the few silver linings of COVID-19,” Professor Boyle said.
“All we’re really asking for is flexibility”.
MBS telehealth changes for consultant physician attendances (items scheduled for removal shaded in green)
|Service||Face-to-face item||Video item||Telephone item|
|Complex initial assessment (at least 45 minutes)||132||92422||92431|
|Complex subsequent assessment (at least 20 minutes)||133||92423||92432|