Medicare claims hit 1 million per day

Medicare is now being billed over one million times a day for the first time in history, as new figures show growth in claims outstripped the number of new patients three-to-one over the past decade.

Page last updated: 03 September 2015

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3 September 2015

Medicare is now being billed over one million times a day for the first time in history, as new figures show growth in claims outstripped the number of new patients three-to-one over the past decade.

Minister for Health Sussan Ley today released the annual Medicare figures for 2014-15, which show 21 million Australians accessed over 368 million individual services on the Medicare Benefit Schedule (MBS) at a cost to taxpayers of over $20 billion.

“About 90 per cent of the population accessed Medicare last year, with taxpayers billed an average of 17 times per patient at a cost of over $800 each in 2014-15,” Ms Ley said.

“Or to put it another way, Medicare was billed an average of one million times every single day last year – the first time this has ever happened.”

Ms Ley said Medicare usage had continued to skyrocket, with MBS claims increasing by about 60 per cent over the past decade and the overall bill to taxpayers increasing 100 per cent.

This is despite the number of new patients accessing Medicare growing at just 21 per cent over the same 10 year period (population growth was 19 per cent between 2004-05 and 2014-15).

“Medicare claims are now an average of $350 a year higher than they were 10 years ago.

“Essentially, we’ve seen the number of Medicare claims triple the growth in new patients over the past decade. This has in turn seen the cost to taxpayers double.

“These figures paint a complex picture around the impacts of Australia’s ageing population and the ever-expanding list of new and improved medical treatments available in our Medicare system.

“That’s why this Government is currently developing a blueprint to build a healthier Medicare that is patient-focussed in direct consultation with clinicians and consumers.”

Ms Ley said there were now more-than 5700 items available for subsidisation on the nation’s Medicare Benefit Schedule – about 1000 extra items than ten years ago – and it was clear the “cupboard needed a deep clean”.

“We’ve seen the size of the Medicare Benefits Schedule expand by about 100 items per year over the past decade,” Ms Ley said.

“It’s a positive that we’re continually discovering and funding new and improved medical treatments to keep us living healthier lives longer, but the challenge is to ensure we’re also improving education and removing out-dated and unproven procedures at the same time.

“It also demonstrates the importance of looking at the way primary health care is delivered overall and whether our current funding model is best supporting the integrated care models millions of Australians living with chronic disease need.

“This includes utilising new technology. Embracing digital health doesn’t mean pushing more people towards ‘Dr Google’ – it’s about enabling clinicians to play an even closer role in the day-to-day management of their patient’s health and that’s a good thing.”

The Abbott Government is currently undertaking a three-pronged approach to Medicare reform, including: a full, clinician-led review of the effectiveness of the more-than 5700 items on the Medicare Benefit Schedule; a full review of the primary care system, including the need for more integrated models; and better education and compliance around MBS items.

“This is in stark contrast to Labor, whose only health policy announced to date is to cut spending – no areas exempt. That means Medicare, hospitals and medicines*.”

Ms Ley said all medical professionals also had a direct role to play in building a healthier Medicare by addressing issues such as over-testing through industry education programs, including Choosing Wisely.

Other statistics released today show bulk billing rates continued to grow to historic highs in 2014-15 at 77.6 per cent for all services (77.2 per cent in 2013-14) and 84.5 per cent for GPs specifically (83.4% per cent in 2013-14).

Ms Ley said the current reviews of the MBS Taskforce and Primary Health Care Advisory Group were due to report to the Government by the end of 2015.

Public consultation is currently being undertaken on a discussion paper from the Primary Health Care Advisory Group – headed by former Australian Medical Association President Dr Steve Hambleton – which can be found on the Department of Health’s website.

2014-15 Annual Medicare Snapshot:

2014-152004-05% Change
Number of Patients21,322,00017,590,00021%
Patients as % of Population89%87.2%2%
Number of Services368,489,000236,316,00056%
Number of Services per Patient17.313.430%
Benefit Paid$20.188 billion$9.922 billion104%
Benefit Per Patient$843$49172%
Number of items on the MBS5754475121%

Labor’s Only Policy on Medicare and Primary Care:

*“the opposition would be kidding itself if it didn't recognise there were challenges in the budget and that savings needed to be found”... “There is no area that is going to be exempt”... “We have to look across the board.”
- Labor Shadow Health Minister Catherine King – 22 Feb 2015 – Sky News


Minister Ley’s Media Contact: James Murphy – 0478 333 974

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