1997-1998
Australia's Commonwealth Department of Health and Family Services, Budget Document 1997-98
Improving health outcomes for the community is the aim of the Federal Government's measure to strengthen the evidence base of medical services funded under the Medicare program.
Fact Sheet 5
Strengthening the evidence base of the Medicare Benefits Schedule
Improving health outcomes for the community is the aim of the Federal Government's measure to strengthen the evidence base of medical services funded under the Medicare program. This will ensure that Medicare benefits are paid only for those procedures supported by evidence as being safe, of benefit to the patient and cost effective.A new body, the Medicare Services Advisory Committee (MSAC), will advise the Minister for Health and Family Services on the inclusion of new procedures and services on the Medicare Benefits Schedule (MBS). MSAC will oversee the assessment of new procedures and the review of existing MBS items. Its advice will be based on evidence relating to the safety, efficacy and cost effectiveness of new and existing medical procedures.
In 1997-98, $1.5 million will be available to support the initiative, including infrastructure and research activities, increasing to $2.5 million in 1998-99, just over $4 million in 1999-2000 and $7 million in 2000-2001. Funding is expected to be available in early 1998.
This investment will produce improved health outcomes and modest savings in Medicare.
The total effect of the measure on the portfolio will be additional expenditure of $1.5 million in 1997-98 and $520,000 in 1998-99, and then savings of $490,000 in 1999-2000 and $3.1 million in 2000-2001.
Consumers
The initiative will assure consumers that new and existing medical procedures have been rigorously evaluated. It takes into account consumers' expectations that the Government will help ensure that medical procedures are thoroughly reviewed before they can attract Medicare benefits. In the longer term, an evidence based approach to MBS listing is expected to lead to better health outcomes for consumers.
The evidence about the medical procedures will be collected through the compilation and analysis of recent research into potential and existing MBS-listed medical procedures. Where appropriate, new research will also be commissioned as part of this process.
The medical profession
The medical profession will have much to gain from this initiative. Medical practitioners will be able to access findings from research compiled or commissioned by MSAC and in some cases to participate in new medical procedures, thus adding to the current body of medical knowledge.
At a practical level, doctors and medical colleges will no longer be asked to compile all the evidence themselves when making a submission for listing of new procedures. In addition, funds may be allocated as part of the research efforts.
However, it will not be possible to fund all requests to evaluate new medical procedures, so there will need to be criteria for funding. Providing interim funding for research purposes will not guarantee automatic listing in the MBS.
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Listing new procedures in the MBS
Medicare benefits are payable for medical procedures appearing in the MBS and are listed on the basis that they are clinically relevant. Until now, the responsibility has been with the Medicare Benefits Advisory Committee (MBAC) and the Medicare Benefits Consultative Committee (MBCC). Both have participation from the medical profession.
Decisions rely too little on comprehensive and systematic evaluation of documented research. With the rapid development of new medical technologies and the need to respond to claims for Medicare benefits, there was limited capacity under the existing arrangements to systematically evaluate procedures.
This initiative is consistent with a strong international movement aimed at building evidence based medicine. This movement is supported by the medical profession, purchasers of health care services and consumers. It is in response to higher costs of health care, rapidly developing medical technologies, and variability in practices among medical professionals and in health outcomes for consumers.
Contact: Gail Batman, First Assistant Secretary, Health Benefits Division. Phone: (06) 289 8227
