The MBS Quality Framework

In the 2009-10 Budget the Australian Government funded the development of a new evidence-based framework for managing the MBS – the MBS Quality Framework. The objectives for the MBS Quality Framework were to strengthen the listing, pricing and review processes of MBS items by ensuring that services are aligned with contemporary clinical evidence, represent best value for money and improve health outcomes for patients.

Page last updated: 16 May 2011

The MBS Quality Framework involved three key elements:

  • introduction of a new evaluation and listing process for MBS items that at that time did not undergo an assessment through the Medical Services Advisory Committee (MSAC);
  • strengthening arrangements for appropriately pricing and listing new MBS services; and
  • establishing systematic MBS monitoring and review processes to inform appropriate amendment or removal of existing MBS items.

The MBS Quality Framework was developed in conjunction with other reform processes that included:

MBS Quality Framework New Listing Process

The previous internal departmental assessment of proposed new MBS items was formalised by developing a consistent and transparent process to determine eligibility for MBS listing informed by independent expert advice. Following the Government’s response to the HTA Review in early 2010 and feedback from stakeholders, MSAC’s role was expanded to provide advice on all proposals relating to amendments to the MBS.

All applications for new MBS items, as well as significant amendments to existing items, will now be referred to MSAC. MSAC’s role as the sole source of expert appraisal and advice ensures consistency and administrative efficiency. The Comprehensive Management Framework for the MBS initiative that was announced in the 2011-12 Budget provides resources for MSAC to carry out the work associated with this expanded role.

Applicants are encouraged to contact the MSAC Secretariat for a preliminary discussion about the application process prior to submitting an application. Information on the process is available at www.msac.gov.au

Reviews of Existing MBS Items

Only a small proportion of services currently funded through the MBS have undergone formal evidence-based assessment. A key component of the MBS Quality Framework was the development of a systematic approach to reviewing existing items to ensure they reflect contemporary evidence, are safe, effective and appropriately used. Details of the first four reviews commenced under the MBS Quality Framework are available at Reviews. These four reviews are expected to be completed in the last half of 2011.

Ongoing, rolling reviews are an important component of the Comprehensive Management Framework for the MBS and additional reviews will commence in 2011-12. Details of new reviews will be disseminated to key stakeholders and made publicly available on the Department’s website.

MBS Fee-Setting

Development of the MBS fee setting process is ongoing at 30 June 2011. When completed it is intended the process will provide recommendations based on specific measureable inputs so that the price of new and, where appropriate, reviewed services will have a strengthened evidence base.

Development work will be further informed by consultation with stakeholders. Details of the proposed fee setting process are available in the MBS Quality Framework Discussion Paper.