2.1: Medicare benefits and general practice development

The 1997-1998 Portfolio Budget Statements, informs Senators and Members of Parliament of the proposed allocation of resources to portfolios outcomes and their objectives and targets including the agencies within the Health and Family Services portfolio.

In this section:

Budget Measures

Objective

To enable eligible patients to obtain appropriate private medical services which are necessary for their health care, without excessive price barriers, through payment of Medicare benefits and associated arrangements.

Priority outcomes

Medicare Benefits Schedule reflects high quality, cost-effective and up-to-date clinical practice.
Growth in Medicare benefits outlays is kept to sustainable levels.
Financial arrangements enable access to necessary and affordable private medical services.
Quality and efficiency are supported and promoted within the medical sector.

Strategies

Undertake systematic reviews of the items and fees in the Medicare Benefits Schedule.
Undertake a comprehensive relative value study of the Medicare Benefits Schedule.
Ensure that any new services for which financial subsidy is provided have been assessed for evidence of safety, efficacy and cost-effectiveness.
Develop and implement approaches to ensure that the growth and distribution of the medical workforce accessing Medicare is appropriate to the needs of the population, including strategies to increase the recruitment and retention of general practitioners in undersupplied rural and remote areas.
Develop and implement structural reform where appropriate, but particularly in relation to general practice, pathology and diagnostic imaging.
Ensure that legislative and administrative arrangements are in place to support appropriate use of the Medicare Benefits Scheme (MBS).
Systematically monitor and assess trends and patterns for the purpose of program review and development.

Performance assessment: indicators and targets

Effectiveness

Indicator	Target	Information source and reporting frequency
Percentage of MBS Services that are bulk-billed (Priority Outcomes 1, 2, 3; Strategies 1, 2, 3, 4, 5, 6, 7)	Significant changes from current 71 per cent to be analysed	Quarterly Medicare Statistics
Number of full time equivalent medical practitioners accessing Medicare (Priority Outcome 2; Strategies 4,8)	Growth rate is slowing towards Australian Medical Workforce Advisory Committee benchmark of 205 clinical practitioners per 100,000 population	Quarterly Medicare Statistics

Efficiency

Indicator	Target	Information source and reporting frequency
MBS benefits growth rates in selected areas eg general practice, pathology, diagnostic imaging (Priority Outcomes 2, 3; Strategies 1, 2, 4, 5, 7)	Growth rates are slowing Pathology growth capped at $924.8 million in 199798	Structured feedback through Budget initiatives Quarterly Quarterly Medicare Statistics
Administration costs (Health Insurance Commission [HIC] and Department) as a percentage of Program costs (Priority Outcomes 2, 3; Strategy 6)	Administration costs are consistent with long term trends ie between 3.5 and 4 per cent	Budget Papers
MBS outlays per capita (Priority Outcome 2; Strategies 1, 2, 3, 4, 5, 6, 7)	Any significant changes from current $330 per capita to be investigated	Budget Papers
Proportion of referred cases completed by the Professional Services Review (PSR) Scheme (Priority Outcomes 3, 4; Strategy 6)	Majority of cases completed within statutory timeframes	PSR Annual report

Quality

Indicator	Target	Information source and reporting frequency
Client views on Medicare service (Priority Outcomes 3, 4, Strategies 1,4,8)	High level of satisfaction	HIC client surveys Annual

Equity

Indicator	Target	Information source and reporting frequency
Percentage of general practitioners and percentage of specialists available in rural and remote areas (Priority Outcomes 3, 4; Strategies 4,5)	Increase in percentage to reduce current shortfall of 445 Full Time Equivalent GPs as identified by Australian Medical Workforce Advisory Committee	Structured feedback from the General Practice Programs Annual

Performance assessment: evaluation

General Practice: There will be a review of General Practice Training and a review of the General Practice Strategy both of which will be ongoing to 1998. These Reviews will be conducted by groups comprised of various different general practitioner perspectives and consumers. They will document the key issues, analyse the strengths and weaknesses and provide advice about future directions.
MBS Relative Value Study: The Relative Value Study of the Medicare Benefits Schedule is a comprehensive review of all items in the General Medical Services Table of the Schedule (ie other than diagnostic services) to determine the relative worth of those services, both within and between sub-specialty groups, and within and between cognitive and procedural services. The Study is expected to continue into 1998.
Pathology Reform Savings Package: The purpose of the evaluation is to measure the success of the Pathology Savings Agreement in restraining growth in Medicare outlays under the Medicare Benefits arrangements, while allowing quality and appropriate services to be provided. Growth rates in Medicare benefits for pathology are being monitored and compared with projected figures based on the agreed target outlays. The evaluation will continue for the life of the Agreement, that is until the end of 1998-99.
Diagnostic Imaging Reform Savings Package: The purpose of the package is to address high growth rates and to bring about structural reform of radiology, nuclear medicine and other areas of diagnostic imaging. The package will promote appropriate, quality and cost-effective diagnostic imaging practice. The effect of the package will be evaluated over the four years to 1999-2000.
Recovery of Compensation Double Dipping: The present Government gave a commitment in Parliament to review the recovery of compensation double dipping after 12 months of operation. The Department is presently preparing a paper for the Minister so that the scope, purpose and timing of such a review can be decided.

How the program is resourced: reconciliation of appropriations to the program and summary of portfolio outlays (Excel 73 KB)

Variations to Program Outlays 1996-97 to 1997-98 (Excel 31 KB)