It appears the RACGP’s wish for increased long consult rebates will be granted.
A long-awaited MBS Review Advisory Committee draft report has validated GP concerns about the inherent unfairness of the time-tiered MBS rebate structure for general practice.
The draft report, which health minister Mark Butler foreshadowed last week, concluded that “the current per-minute differences between short and longer consultations is too great”.
It recommended that the benefits for time-tiered items “equitably support appropriate and varied consultation lengths to ensure patients can access care that meets their individual clinical needs”.
The working group felt it was still “reasonable” for shorter consults to have a higher per-minute rebate attached, in recognition of a “relatively higher” administrative burden attached to shorter visits.
There were three key options identified – increasing the fee for level C, D and E consults, moving to a seven-tier structure and converting the rebates into “time blocks” with a flag fall for the initial block.
The first two options will be familiar to those who have followed the ongoing debate as the proffered solutions of the RACGP and AMA respectively.
Where the RACGP has long called for a 20% to 40% boost to rebates for level C, D and E consults, the AMA’s vision for reform involves restructuring the tiers completely, adding in two completely new rebate levels.
The MRAC draft report appeared to lean toward the RACGP’s solution.
“… Given the complexity of changing the overall time-tiered framework (for example, as per the AMA proposal), the [time-tiered item working group] acknowledged that increasing the fees for levels C–E is the option that could be implemented fastest,” the report reads.
“However, doing so would not preclude longer term changes to the time-tiered structure.”
The draft report also recommended that bulk billing incentives be based on a percentage of the MBS fee for the service that is bulk billed, rather than be a flat fee, to avoid furthering the “disproportionate remuneration of shorter consultations when compared to longer consultations”.
The working group felt that rural loadings for bulk-billing incentives were “appropriate and should be retained” under the RACGP’s proposed changes.
This story will be updated.
