MBS reforms unlikely to have great impact on GP consultation patterns
Medicare reforms recently introduced by the Federal Government, including changes to Levels B, C and D consultation item descriptors, may not be sufficient to change consultation patterns in general practice to better match health policy objectives, according to research published in the Medical Journal of Australia.
Dr Michael Taylor, Research Fellow at the Australian Institute for Primary Care at La Trobe University, Melbourne, and co-authors conducted a retrospective analysis of more than one billion Medicare claims made between 1994 and 2009 for general practice standard consultations, health assessments, care plans and other special MBS items.
They found that the use of Levels C and D (long) consultations increased consistently from 1994 to 2004, but declined dramatically by 2009. This was accompanied by an increase in the use of Level A (short) consultations.
Dr Taylor said the pattern was at odds with health policy objectives that relied on long consultations to provide preventive care and chronic disease management.
“The Federal Government intends the May 2010 MBS reforms to encourage preventive care through the use of long consultations,” Dr Taylor said.
“These reforms are likely to influence consultation patterns, but perhaps not sufficiently to overcome other factors, and the classic friction between professional and bureaucratic interests will remain.
“Further research will be necessary to establish what effect these recent reforms will have on consultation utilisation.”
In an accompanying commentary in the MJA, Prof Helena Britt, Director of the Family Medicine Research Centre at the University of Sydney, and co-authors write that data from the Bettering the Evaluation and Care of Health (BEACH) program suggest that most of the recent increase in claims for Level A consultations can be attributed to greater use of practice nurses.
“The introduction of MBS items for practice nurses in May 2004 had a significant impact on GPs’ use of Level A consultations,” Prof Britt said.
“At the majority of Level A consultations they are passing the patient on to the nurse, and claiming a Level A for their own time.
“The newly announced enhanced role for practice nurses in primary health care (the Federal Government’s 2010 Budget), planned to commence in 2012, may further influence GPs’ utilisation of short consultations.”
The Medical Journal of Australia is a publication of the Australian Medical Association.
The statements or opinions that are expressed in the MJA reflect the views of the authors and do not represent the official policy of the AMA unless that is so stated.
CONTACT: Dr Michael Taylor 0421 339 908
Mr Mark Pearce 0423 783 756
(Media and Communications Manager La Trobe Uni)
Prof Helena Britt 0411 197 938
Rachel Gleeson 02 9351 4312
(Media Unit, Uni Syd)
