Participation pack: MBS Review stakeholder forum

Powerpoint presentation used as a basis for discussion at the Adelaide and Perth forums in July 2015.

Page last updated: 25 February 2016

Note. This document is provided for reference only as it has been superseded by the consultation paper.

PDF version: Participation pack: MBS Review stakeholder forum (PDF 293 KB)

Slide 1: MBS Review stakeholder forum

Your name: [space to fill in your name]
Your role/organisation: [space to fill in your role/organisation]

Please use this document to record your thoughts and leave it on the table or hand to one of the facilitators at the end of the forum.

Perth, 25 July 2015

Slide 2: Agenda

TimeDurationTopic
9:0030 minsIntroduction
9:3015 minsWhat are the major shifts we need to make to how the MBS works?
9:4530 minsWhat specific issues should the review consider? (Groups of 10)
10:1515 minsWhat barriers will we need to address in changing the MBS?
10:3015 minsBreak
10:4530 minsQ&A
11:1515 minsHow should we prioritise where to focus?
11:3015 minsWhat are the most effective methods for consulting stakeholders?
11:4515 minsNominations and wrap-up
Top of page

Slide 3: Agenda item - Introduction

Slide 4: Terms of reference for the MBS reviews

In scope

  • All current MBS items and the services they describe
  • Increasing the value derived from services
  • Concerns about safety, clinically unnecessary service provision and concurrence with guidelines
  • Evidence for services, appropriateness, best practice options, levels and frequency of support
  • Legislation and rules that underpin the MBS

Out of scope

  • Division of responsibilities between Governments – Federation White Paper
  • Innovative funding models for chronic and complex – Primary Health Care Advisory Group
  • Introduction of new MBS services – Medical Services Advisory Committee
  • No savings target – scope for reinvestment Top of page

Slide 5: Agenda item - What are the major shifts we need to make to how the MBS works?

Slide 6: What are the major shifts we need to make?

FromTo
Sickness focusWellness focus
Silo structureSystem view, team based
Activity focusOutcome focus
OpaqueTransparent (evidence based, data driven, linked/ integrated)
Inflexible, discreteFlexible, bundled
StaticDynamic and evolving
Dense and lengthySimple and short
Fees out of step with cost of deliveryFees aligned to cost
Top of page

Slide 7: Agenda item - What specific issues should the review consider?

Slide 8: There are a variety of reasons to change something in the MBS

  • Obsolescence
  • Indication creep
  • Inappropriate frequency/ intensity
  • Pricing failure
  • Bundling/ unbundling

Slide 9: What specific changes should the review consider?

Please discuss specific changes in your groups and populate this page. Consider:
  • macro/ system changes e.g. increase frequency of MBS review
  • cross-discipline changes e.g. identify substantial mismatches between prices and cost of delivery
  • specific changes to item numbers e.g. review of #22020 and investigate whether to bundle this item Top of page

Slide 10: Agenda item - What barriers will we need to address in changing the MBS?

Slide 11: Barriers and how we overcome them

What are the barriers?How can we overcome them?
Skepticism on purpose/goal from public, cliniciansCommunication – case for change – and consultation
Financial implications – self interestRobust commercial model
Lack of research / evidenceBuild behind evidence base / gather
"Here we go again"Communication – evidence of political will
Poor data availabilityUse linked systems (and improve)/ better use data we have
InertiaClear articulation of benefits and reasons for change
Workload and magnitude of change Well-designed implementation
Top of page

Slide 12: Agenda item - How should we prioritise where to focus?

Slide 13: How should we prioritise them?

  • Various category filters
    • Disease types
    • Patient types
    • Craft groups
    • Areas where models of care rapidly changing
    • Areas with poor outcomes
  • High cost / volume (some debate volume?)
  • Items with rapid growth
  • Degree to which obsolete / unnecessary
  • “High priority rules” (e.g., referral requirements)
  • Consensus view / expert hypothesis
  • Complaint volumes
  • Variation – geographic, provider
  • Feasibility
Question – should the approach vary across disciplines? Top of page

Slide 14: Agenda item - What are the most effective methods for consulting stakeholders?

Slide 15: What are the most effective methods for consulting stakeholders?

Consumer

  • Consumer groups / focus groups
  • Citizen juries
  • Social media
  • Engage through clinicians
  • Case studies
  • Issues / discussion areas
    • Expert consumer vs “normal” consumer
    • Co-design
    • Survey/email
    • Inform them beforehand
    • Potentially chair Discipline Groups Top of page

Clinicians

  • Peak bodies / Colleges / Boards
  • Case studies
  • Scientific meetings
  • Written submissions / consultations (2-3 month window)
  • Issues / discussion areas
    • "Scare campaigns"
    • Nominate champions
    • Next generation of leaders

Other

  • Media – educate, engage
  • Q&A response sheets
  • Lots of various stakeholders listed! Top of page

Slide 16: Who would you like to nominate for the Discipline Groups?

Provide name of nominee, organisation, and specialty/expertise.

Slide 17: email address

email MBS Reviews