New Australian research casts doubt on the ability of MyMedicare to meet one of its primary goals.
Patient registration systems in other countries don’t necessarily lead to improved continuity of care – making it crucial for the government to keep checking in on MyMedicare, says new research published in the Medical Journal of Australia.
The paper, which was co-authored by RACGP president Dr Michael Wright and incoming national Chief Medical Officer Professor Michael Kidd, compared 24 peer-reviewed publications looking at the efficacy of patient enrolment systems, in light of Australia’s nascent MyMedicare scheme.
These included schemes in the UK, Canada, Ireland, New Zealand, Denmark, France, Germany, Israel, Italy, the Netherlands, Norway, Sweden and Switzerland.
While enrolment generally allowed for better planning and greater practice efficiency, it was also found to be a barrier to access and continuity of care in areas where there were long waiting lists.
This was particularly true where funding was inadequate or reforms were complex.
“People are more likely to enrol with a general practitioner or practice when they perceive that it benefits them, regardless of the service funding model,” the researchers from the UNSW International Centre for Future Health Systems wrote in the MJA.
“Their preference for continuity of care was indicated by the fact that their choice of ‘usual general practitioner’ was not necessarily based on convenience or proximity.
“Older people (for example, people aged 45 years or older), women, people from higher socio‐economic areas, and people with chronic or multiple medical conditions were both more likely to enrol in voluntary registration schemes and to have usual general practitioners than younger people (for example, people aged 15–24 years), men, and people from marginalised groups, including recent migrants and First Nations people.”
On the practice side, clinics were more likely to register patients if it was encouraged by the payment model and were discouraged from registering patients if the process was too complex.
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According to federal health minister Mark Butler, approximately 80% of Australia’s GP clinics had registered to participate in MyMedicare as of November 2024.
Officially, the voluntary patient enrolment program has four key benefits to patients: fostering continuity of care, allowing access to longer MBS telehealth consults, applying the tripled bulk-billing incentive to those consults and facilitating more regular GP visits for patients living in residential aged care.
The new paper found little evidence to suggest that patient enrolment schemes helped to meet this first goal.
“If you look at the Australian data, a lot of people in Australia [already] have a natural preference to see a regular GP,” lead author Dr Shona Bates told The Medical Republic.
“When you introduce enrolment, it doesn’t necessarily have a massive impact on continuity of care, because it’s naturally preferred by patients anyway.
“But what it does do is allow practices to manage work flows and enable government to plan and deliver other reforms.”
MyMedicare, the MJA paper noted, currently only offers limited incentives for patients to choose a single provider.
“For MyMedicare to work, practices and patients need to see value in enrolment,” the researchers wrote.
“This will be difficult to establish without more targeted evaluation of its benefits, not just for those who have usual general practitioners, but also for those who do not.
“The limited incentives offered by MyMedicare mean that it is an opportunity for studying the impact of patient registration on continuity of care when most people may not benefit from the incentives.”
The next addition to MyMedicare – a GP chronic condition management plan item to replace GP management plan and Team Care Arrangement items – is still scheduled for 1 July of this year.
No further details on the costings of the new items have been released.
