Evaluation of the National External Breast Prostheses Reimbursement Program

2.2 Administration review

Page last updated: 05 November 2010

2.2.1 Review of Medicare Australia program data

Medicare Australia is required to provide monthly end-of-financial year data to the department on a number of items identified on the program claim form, including the number of reimbursements, total amount reimbursed, demographic data and process performance.

Urbis undertook two reviews of Medicare Australia data prior to both the first progress report in November 2009, and the second progress report in March 2010. These findings are discussed further in section 3.2 of this report.

2.2.2 Review of relevant documentation

A review of other relevant documentation was also undertaken to inform the evaluation. This included a review of the service arrangement and business rules between the department and Medicare Australia, as well as recent research on breast cancer. A discussion of relevant documentation is included in chapter three of this report.

2.2.3 Interviews with stakeholders

The stakeholder interviews were conducted through the months of March to May 2010 and formed the final phase of the evaluation. The aim of these interviews was to inform both the administrative and impact components of the evaluation.

Stakeholders included the following individuals and organisations:
  • Medicare Australia
  • the department
  • selected state and territory government departments
  • state and territory Cancer Councils
  • peak bodies and advocacy groups for women with breast cancer
  • cancer support groups and services
  • health care professionals, including breast cancer surgeons and McGrath Foundation breast care nurses
  • breast prosthesis fitters and suppliers.
A full list of the stakeholders consulted can be found at Appendix B. Altogether, 44 individuals from 27 organisations were consulted as part of this component.

The interviews were conducted by telephone except for consultations with the department, Medicare Australia and the National Breast Cancer Foundation which were conducted face to face. Two stakeholders provided written feedback.

The interviews followed formal discussion guides which were developed in consultation with the department. All discussion guides can be found at Appendix C.