1997-1998
Australia's Commonwealth Department of Health and Family Services, Budget Document 1997-98
The Budget contains funding for a range of initiatives designed to further streamline the efficiency of the Medicare Payments System, increase Medicare Benefits Schedule fees for doctors and promote improved patient outcomes through the General Practice Strategy.
Fact Sheet 6
Electronic commerce heads reforms to Medicare Benefits and General Practice
The Budget contains funding for a range of initiatives designed to further streamline the efficiency of the Medicare Payments System, increase Medicare Benefits Schedule fees for doctors and promote improved patient outcomes through the General Practice Strategy.Introduction of electronic commerce for Medicare claim processing
People will have the option of electronically lodging their Medicare claims directly from doctors' surgeries. It will substantially improve access to Medicare services, especially for many people in rural and remote areas.
Doctors will be able to electronically lodge claims for all Medicare services, instead of only for bulk billed claims. Electronically lodged Medicare claims generally will be processed more quickly than paper based claims, as lodging claims at the point of service will help reduce payment delays. Existing payment arrangements, including bulk billing, will still apply.
The costs of this measure are costs to Medicare benefits caused by reduced payment delays from electronic claiming. These are transitional costs over the medium term and will not impact when the new system is fully implemented.
The savings from more efficient payment of benefits will obviate the need to close rural Medicare offices following the introduction of the pharmacy claiming process and will provide funding to offset some of the costs of separation of Medibank Private from the Health Insurance Commission.
A gradual uptake of this option is expected over the next four years.
The total effect of the measure on the portfolio is as follows:
1997-98 $m | 1998-99 $m | 1999-2000 $m | 2000-2001 $m |
-0.1 | 0.1 | 11.7 | 16.4 |
Medicare fee increase
Doctors will benefit from a general increase in Medicare Schedule fees for 1997-98 of approximately 1.7%.
There will be a 0.85% increase in the Schedule fees for General Practitioner Attendance items, (eg the Medicare Schedule fee for a level B consultation is expected to rise to $24.70) with the balance of the fee increase available through the General Practice Strategy.
There will be no increase in the Schedule fees for the Other Non-referred Attendance items, Family Group Therapy items or the Acupuncture item.
The fee increase will come into effect on 1 November 1997.
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General practice strategy
As a crucial element of the commitment to improving and supporting General Practice, the Government will review the current General Practice Strategy in consultation with the medical profession. The Government intends to work with the profession to develop alternative approaches to General Practice funding that will reinforce and promote strategies which achieve positive outcomes for patients.
This may include, for example, support for initiatives that provide best practice management of chronic conditions such as diabetes and asthma, that participate in preventive health measures such as cervical cancer screening and mammography, and can demonstrate appropriate prescribing and pathology ordering.
The precise nature of these activities, and the outcomes at which they are directed, will be determined in consultation with the profession. The resulting improvement in patient health will, in turn, reduce the call on Medicare funds.
Changes to the Better Practice Program to reflect the new arrangements are expected to be in place by 1 February 1998.
The total effect of the measure on the portfolio is as follows:
1997-98 $m | 1998-99 $m | 1999-2000 $m | 2000-2001 $m |
-34.4 | -28.0 | -37.9 | -39.9 |
Further savings of approximately $8 million over four years will be achieved by merging two components of the Strategy relating to evaluation, and reducing the allocation to reflect actual spending levels. The merged program will continue the work of the existing programs.
The effect of the merging of these components is as follows:
1997-98 $m | 1998-99 $m | 1999-2000 $m | 2000-2001 $m |
-2.0 | -2.0 | -2.1 | -2.1 |
Medicare benefits for optometrical consultations
An agreement has been reached with the Australian Optometrical Association which will promote appropriate and cost effective patient care, as well as significantly reducing Medicare payments.
The agreement will result in restructuring the descriptions and fees for some items in the Medicare Schedule for consultations by optometrists.
Areas targeted for restructure include the payment of Medicare benefits for a second comprehensive consultation within two years unless there is a genuine clinical need and tightening of the conditions for contact lens prescriptions.
The change to the contact lens items will affect patients who have myopia of greater than 4.00 dioptres but less than 5.00 dioptres. Previously patients with myopia at 4.00 dioptres or greater were eligible for Medicare benefits for contact lens prescriptions. The change has been introduced as a result of the improved effectiveness of spectacle lens material, now available for disorders within the range of 4.00 to 5.00 dioptres.
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The measure will come into effect on 1 November 1997, and its total effect on the portfolio is as follows:
1997-98 $m | 1998-99 $m | 1999-2000 $m | 2000-2001 $m |
-7.8 | -13.9 | -14.8 | -15.5 |
Medicare benefits for home visits
The Government will make savings of $13 million over the next four years in payments to non-specialists for home visits. Currently, the arrangements make no allowance for the number of patients seen at each location. For example, if three people are seen at a single location, the loading is paid three times.
However, from 1 November 1997, Medicare benefits for home visits by non-specialists will be paid on the same basis as Medicare benefits for non-specialist consultations at all other locations away from the surgery (eg hospitals, nursing homes).
The total effect of the measure on the portfolio is as follows:
1997-98 $m | 1998-99 $m | 1999-2000 $m | 2000-2001 $m |
-2.0 | -3.5 | -3.7 | -3.8 |
Contacts:
Medicare: Gail Batman, First Assistant Secretary, Health Benefits Division. Phone: (06) 289 8227
General Practice: Vin McLoughlin, Assistant Secretary, General Practice Branch. Phone: (06) 289 3604
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