New COVID consultation Medicare numbers welcome, but misguided

On 23 June, the Federal Government announced extra funding for longer GP consultations to inform patients of the benefits of vaccination against COVID-19 and assist them in making informed decisions.

For several months, the AMA had been raising the need for GPs to spend more time with patients with the Prime Minister and the Minister for Health, and was pleased with the Government's announcement of new Medicare item numbers for longer COVID-19 assessment consultations.

However, the announcement occurred just as the Australian Technical Advisory Group on Immunisation (ATAGI) lifted the age for the AstraZeneca vaccine for patients 60 years and over.

The change in guidance caused more confusion amongst patients and further exacerbated the need for GPs to spend more time with patients allaying concerns over COVID-19 vaccinations and answering questions.

While it is a step in the right direction for the Federal Government to recognise the time GPs and their staff are spending reassuring patients about the AstraZeneca vaccine, we are disappointed that the new item numbers are tied to the vaccination itself and bulk billing.

As one member commented “the new item is yet another ‘disease specific’ one which appears to be more for media consumption than to address the real situation as GPs attempt to protect patients from COVID in an environment that changes daily.”

The new item numbers show a lack of understanding about how patients approach and discuss these issues with their GP and how GPs are administering their limited vaccine allocations.

It appears that the new Medicare item numbers for vaccine counselling are required to occur just before a patient receives the jab. However, the vast majority of patients want to discuss COVID-19 vaccines with their GP well in advance of receiving a dose. In addition, most GPs are holding vaccine clinics on a given day and specific timeframe to ensure maximum efficiency, no wastage of their small allocation of vaccines and appropriate supervision of patients post-vaccine.

GPs have told us that most patients book a regular consult and that COVID-19 vaccination discussions are a ‘tag on topic’ after the main reason for the consultation is completed. This can take 5-10 minutes on top of their scheduled appointment and the patient may or may not book their vaccination after this consult.

The new item numbers also forces the GP to bulk bill the consultation and we are of the firm belief that no Medicare item should require mandatory bulk billing. The bulk billing rates set by the Federal Government fall woefully short of the true cost of delivering quality primary care to the community and hinder the ability for GPs to sustain viable businesses.

Finally, GPs must know of changes to vaccine guidance before it is public so they can understand the new information, prepare for the impacts to their bookings and vaccine clinics, and be able to explain the changes to their patients.

We will continue to lobby the Federal Government to change the new COVID discussion item numbers to be:

• unlinked to the vaccination;
• untimed;
• billed in conjunction with a regular attendance item; and
• not require mandatory bulk billing.