Medicare reforms and reviews

We conduct independent reviews of Medicare, the Medicare Benefits Schedule (MBS), the Pharmaceutical Benefits Scheme (PBS) Schedule and specific MBS and PBS items. This helps ensure our healthcare system stays up to date with the latest research and practices.

What reforms and reviews are

Reviews help us find ways to improve our processes to make them more efficient and effective.

Reviews might look at things like:

  • current processes and practices
  • the latest relevant research
  • emerging treatments and technologies
  • international best practice.

They can help determine whether we need to reform the way we do things to improve outcomes.

We regularly review:

We also conduct post-market reviews of PBS medicines to ensure they continue to do what they claim and remain as safe as possible for Australians.

Why they are important

Medicines, treatments, health technologies and healthcare practices evolve all the time. Regular reviews and reforms help to keep our healthcare system up to date with new developments and practices and safer for all Australians.

Timing of reforms and reviews

We start most review processes based on need.

Some of our reviews are ongoing, including:

Who is involved in reforms and reviews

We use committees and groups to work on specific topics or issues. We often engage the specialist expertise of our stakeholders to help us.

We consult with stakeholders to help us understand the issues and the needs of the community. 

What we do with the results

At the end of the review process, the Australian Government considers any recommendations, and where appropriate publishes its response.

Some changes can take place without additional cost. For more significant changes that need extra funding, the Australian Government might allocate funding in the Budget process to implement them over time.

Current and previous Medicare reforms and reviews

Between 2015 and 2020, the MBS Review considered how MBS items could be better aligned with current clinical evidence and practice. The Australian Government has been progressively considering and implementing the recommendations.

The MBS Continuous Review builds on the work of the MBS Review. It involves the ongoing review of Medicare items and services by experts to ensure the MBS:

  • continues to support high-quality care
  • remains flexible and current. 
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