RACGP provided a statement reiterating its support for time-tiered items for medical specialists as well as the simplifying of case conferencing items.
A report was released by The Specialist and Consultant Physician Clinical Committee (the Committee) as a part of the Medical Benefits Schedule Review (MBS) Taskforce that seeks to investigate and analyse items associated with professional attendances for specialists who aren’t GPs or consultant physicians.
The following are the recommendations provided by the report:
· Replacement of items for opening and following attendance items with time-tiered attendances
· Provision of a new framework for the benefit of case conference items
· Retention rule of the existing specialist-to-specialist recommendation validity period
RACGP submitted a report to the Committee that contains member-informed feedbacks and suggestions to serve as recommendations.
Time-tiered items and value disparities in the MBS
The said report, the support pledged by RACGP was reinstated that recommends time-tiered items for non-specialist GPs as a replacement of the existing scheme.
Among the advantages that are highlighted by the submission is that it could remove the giving of financial incentive to a non-GP specialist whenever referrals are done by consultant physicians which send patients back to the GPs. The RACGP found this particular issue problematic.
Moreover, the use of time-tiered items would follow the same as those currently used for general practice. It is the belief of the college that the benefits of its use would lie on the efficient use of consultation time and would address the 18.5% value disparity within MBS between medical specialists and GP.
RACGP recognizes that the committee report does not provide fees for the new time tiers considering that it is beyond the scope. However, RACGP made it clear that when the methodology of setting fees has been set, the application should cover all MBS attendance items to secure transparency in rebates and remove gaps between GPs and other medical specialists.
Another recommendation forwarded is the replacement of the term ‘specialist’ that is used in the MBS to refer to a subset of medical specialists. This replacement is perceived to provide better clarification that would prevent undervaluing the GP role in providing healthcare by highlighting that GPs are not medical specialists.
A new framework for case conference items and complexity
RACGP maintained that simplification of the existing case conference structure should push through, referring to such as general practice case conferencing items which is associated with either organising, coordination or participating and are divided into time-tiers.
Although RACGP supports the inclusion of GPs in case conferences for the promotion of care continuity, they remained unsupportive of mandating the GP participation. According to the report submitted, case conferences can be logistically difficult to organise and requiring GP involvement would worsen the said instance. However, RACGP recommended that GP participation should be encouraged. In this sense, GPs are involved in discussing the proper and appropriate means in dealing with the patients and other professionals.
Specialist-to-specialist referral validity period
The committee suggested the retention of the existing 3-month validity period rather than increasing it to 6 months. RACGP clarified its support to the suggestion, believing that it would provide longer-term management of patients in coordination with their GP and specialist-to-specialist relations should only be done in a short period of time.
RACGP also called for transparency and assessment of the changes done in the MBS review, providing that it should be subjected to serious monitoring, analysis, evaluation and consultation with people involved to secure that the expected results are achieved.
