Re-examining the Medical Benefits Schedule (MBS)
The recent ABC Four Corners exposé of medical waste reinforces the urgent need to re-examine the continued inclusion of a range of medical procedures and treatments on the Medical Benefits Schedule (MBS) in light of the current evidence about efficacy, safety and cost-effectiveness.
The Australian Pain Management Association (APMA) strongly supports call from a wide range of bodies, including eminent clinicians and health experts involved in the Choosing Wisely campaign, for a comprehensive review of the MBS. The review needs to not only examine which procedures and treatments should continue to be eligible for Medicare funding, but also whether particular diagnostic or clinical features are necessary before the procedures can be funded.
“Consumers expect that the care they receive will lead to an improved outcome and quality of life,” Elizabeth Carrigan APMA CEO said. “But we know that in the area of pain management, enormous amounts are being spent by the Government and consumers themselves on procedures and treatments that are not supported by evidence and in many cases actually harming consumers. These include many of the MRI scans for knee pain, leading to unnecessary arthroscopies and knee replacements, and imaging for lower back pain on initial presentation.”
In April the Minister for Health Sussan Ley MP announced a review of the MBS, to be undertaken by a Medicare Benefits Schedule Review Taskforce (the Taskforce). The Taskforce has recently released a consultation paper (PDF1.11 MB) (Word922.84 KB) and invited submissions. APMA welcomes comments from the Minister for Health Sussan Ley that this will open up the opportunity to list new treatment items - some of which are presently not funded through the MBS but which have already been adopted as best practice.
An important objective of the review will be curbing inefficiency by ensuring that low-value services—that is, services which provide no or negligible clinical benefit and, in some cases, might actually do harm to patients—cease being funded. The approach will be ensuring that MBS items are evidence-based, fit-for-purpose and reflect contemporary medical practice. An evidence-based MBS underpins best clinical practice and facilitates better health outcomes for patients.
As the Consumers Health Forum has observed, “Consumers are the ones who have to live with the consequences of an unwarranted procedure. They should be able to question their doctor about the necessity of proposed health interventions and be part of the decision on whether a test or procedure is right for them. The evidence to inform that decision needs to be clear and accessible.”
APMA hopes that the Four Corners program will be the catalyst for further action to give consumers confidence in the quality of the care they receive and enable the realisation of the Taskforce’s vision that the MBS provide
”affordable universal access to best practice health services that represent value for money for the individual patient and the health system.”