Anaesthesia MBS Review

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The Report from Anaesthesia Clinical Committee (ACC) of the Medicare Benefits Schedule (MBS) Review Taskforce 2017 has just been released by the Australian Federal Department of Health.

 

Anaesthesia MBS Review

Key Messages

  • There has been nearly 2 years of advocacy by the ASA in order to safeguard the current Anaesthesia MBS, and to maintain it as being accessible, appropriate, balanced and cost-effective to all Australians.
  • The MBS Review Taskforce has just released the Report from the ACC.
  • The ASA has responded to the ACC Report, and has provided exhaustive rebuttals to the proposed changes in the Anaesthesia MBS.
  • As a result of our advocacy, the ASA expects that the Federal Government will adopt a small subset of ACC Report recommendations.
  • An agreed structure has been developed by which an Anaesthesia Liaison Group (ALG), with ASA guidance, will be working with the Department for all future changes to the Anaesthesia MBS.

Background

For almost 2 years now, the ASA has held extensive and constructive discussions with the Federal Department of Health and the Federal Government to ensure that any changes to the Anaesthesia MBS would not disadvantage vulnerable patients, would provide value for money, and would enable affordable and universal access to medical care.

A highly effective ASA Anaesthesia MBS Review Working Group was established in 2017. By collaboration with other key ASA personnel, ANZCA, and academic institutions, and with strong support from the AMA, there has been an extraordinary commitment in the struggle to preserve an Anaesthesia MBS which has served extremely well the Australian public and healthcare sector since it was introduced in 2001. Far in excess of 2000 cumulative hours have been clocked up, especially during the past 20 months, including around 3000 emails, not to mention phone calls, teleconferences, meetings, and visits to and from Canberra, Adelaide, Melbourne and Sydney.

  1. ACC report
  2. ASA full response
  3. AMA submission

Summary of the ASA Response to the ACC Report

The ASA has significant concerns with the following key aspects of the majority of the recommendations by the ACC:

  • Lack of an evidence-based approach to modification of MBS item numbers;
  • Inconsistencies in recommendations between Clinical Committee reports;
  • Erosion of patient-centred care and the targeting of vulnerable community groups, such as the elderly, the most unwell, pregnant women, and people with mental health issues;
  • Undermining of anaesthesia as a specialty;
  • No evidence of collaboration with the majority of Australian anaesthetists;
  • Inadequate consumer engagement;
  • No consideration of the consequences for patients, particularly on out-of-pocket costs, maldistribution of funding, access to essential clinical services, and the unbalancing of private/public healthcare in Australia.

The ASA agrees with 19 recommendations contained within the ACC Report. Implementation of these 19 proposals will balance the need to achieve the goals of the MBS Review, whilst protecting those patient groups at risk of being imposed with an added and unfair financial burden, achieving individualised care and preserving the integrity of the great and indispensable specialty of anaesthesia in Australia.

Our committed efforts and co-operation with the Federal Department and Government in providing comprehensive responses to the ACC Report, has resulted in greater understanding of the unique issues of anaesthesia, and the importance of maintaining the current Anaesthesia MBS. As such, we believe that a small number of items will be accepted by the Government for a pending budgetary review.

Finally and importantly, as a result of the ASA’s ongoing advocacy and determination, a future framework for the ongoing Anaesthesia MBS has been advanced. An ALG, with strong ASA involvement, will be working with the Department for all future changes to, and stewardship of, the Anaesthesia MBS.

Read more on ASA Engagement in the MBS Review: public | members

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Dr Peter Seal

ASA President