Medicare Benefits Schedule (MBS) Review

About the initiative

The Medicare Benefits Schedule (MBS) is a list of health professional services that the Australian Government subsidises. MBS items provide patient benefits for a wide range of health services including consultations, diagnostic tests and operations.

Between 2015 and 2020, the MBS Review Taskforce looked at more than 5,700 MBS items to see if they needed to be amended, updated or removed. It identified services that were obsolete, outdated or potentially unsafe.

The taskforce also recommended adding new items where needed, along with broader structural changes to the MBS.   

Why it is important

This was the most thorough review of Medicare since it began in 1984. The review process is an important step towards safer, more modern care for all Australians.

Goals

This review aimed to improve the MBS by:

• updating the MBS to reflect modern medical practices and ensure patient safety
• delivering greater consistency and clarity across different parts of the MBS
• promoting better use of data and evidence to support MBS services.

Review process

Consultation with stakeholders was central to the MBS Review. The taskforce received feedback from thousands of stakeholders, which helped inform its final recommendations to the Government.

The process was as follows:

• Taskforce established. The Government established the MBS Review Taskforce to address feedback from clinicians and the broader community that some services on the MBS did not reflect clinical best practice. The MBS Review Taskforce considered more than 5,700 items on the MBS. It looked at how the items could be aligned with contemporary clinical evidence and practice and improve health outcomes for all Australians.
• Committees established. The taskforce set up discipline-specific clinical committees and working groups, which reviewed a defined range of existing MBS items. The Principles and Rules Committee reviewed the enforceable rules and regulations underpinning the MBS, to ensure they were up-to-date and supported contemporary clinical practice.
• Public consulted. The committees released their reports with draft recommendations and invited stakeholder feedback. The recommendations did not represent the final position on items, but were subject to stakeholder and taskforce consideration.
• Committees considered public feedback. The committees assessed the advice from public consultation and decided if any changes were needed to the recommendations. They then sent their recommendations to the MBS Review Taskforce.
• Taskforce considered committee and public feedback. The taskforce considered committees’ recommendations and the information provided by the public to make sure that all the main concerns were addressed.
• Taskforce delivered final recommendations to government. The taskforce delivered recommendations throughout the MBS Review process, and delivered their final report in December 2020. 
• Taskforce developed ongoing system of review. This will make sure the MBS remains up-to-date.
• Government progressively considers taskforce recommendations and implements changes as agreed. The end result of the process is a better MBS for all Australians.

This work continues under the MBS Continuous Review.

Clinical committees

The taskforce established over 100 clinical committees and working groups to give it expert advice about each area of clinical practice that the MBS supports.

Clinical committees and their working groups examined MBS items in a particular clinical area, to align those items with modern clinical evidence and best practice. Over 700 clinicians, consumers and health system experts participated in these committees, providing detailed advice on how to improve the MBS.

Clinical committees consisted of a Chair who was a clinician practising in the area under review, and members including:

• other clinicians
• health system experts
• general practitioners
• consumers.

The committees sometimes set up working groups and reference groups to consider targeted clinical issues. Some working groups reported directly to the taskforce, and others through the clinical committee.

See the clinical committee reports.  

Primary Care process

Several groups reviewed Primary Care items:

• General Practice Primary Care Clinical Committee (GPPCCC)
• 6 Primary Care Reference Groups.

After public consultation, these groups submitted final reports to the MBS Review Taskforce in August 2019.

The taskforce noted that there was significant overlap across the 101 recommendations. It then assessed the recommendations individually and as part of theme groups to create a final overarching report. The section ‘Key themes’ in the final Primary Care report outlines this process.

Developing a consistent report meant that the taskforce’s Primary Care recommendations:

• were consistent
• did not fragment patient care
• did not create unintended consequences.

You can read the taskforce reports on Primary Care, including its findings on each Primary Care Reference Group report.

Reports

The MBS Review Taskforce delivered its final report in December 2020. Between 2015 and 2020 it delivered over 60 detailed clinical reports containing more than 1,400 recommendations  to the Australian Government for consideration. See our collection of MBS Review Taskforce reports and recommendations.

Implementation

The Government decides whether to adopt the recommendations. Once it supports a recommendation, work begins on implementing the resulting changes.

Implementation timing may vary because of complexity and impacts on stakeholders. We understand that many people want an immediate response and change. However, the taskforce’s recommendations are significant in number, scale and scope.

It can take 12 to 18 months to implement a change. Changes to MBS items require:

• regulatory changes
• mapping changes – advising practitioners, hospitals, insurers and other stakeholders
• updating IT payment systems
• updating MBS Online
• advising stakeholders through webinars and fact sheets.

Implementation timeline

Ongoing consultation

We are establishing Implementation Liaison Groups (ILGs) for ongoing stakeholder consultation. As we work to adopt recommendations, these groups help us to:

• make changes in a way that best meets patients’ safety and care needs
• make sure there are no unintended consequences.

ILG members are generally professional organisations, practicing clinicians, and consumer representatives. For more information on ILGs, contact us.

Status

The Government began responding to Taskforce recommendations in 2016. Through Budget cycles it has progressively announced changes to the MBS arising from Taskforce recommendations.

Further details on the changes to the MBS in response to Taskforce's recommendations are available on the MBS Review – Government responses page.

This work continues under the MBS Continuous Review.

News and updates

When the Government endorses implementation of a recommendation, we announce it through:

• a newsletter for stakeholders
• information about Government responses on our website
• implementation advice through news items and fact sheets on MBS Online
• announcements in the Government’s annual Budget and Mid‑Year Economic and Fiscal Outlook.

Contact