A plan before the federal government to scrap Medicare funding for initial specialist consultations conducted via telehealth is unsupported by evidence and would undermine access to care, it is being argued.
The recommendation was put forward late last year by the MBS Review Advisory Committee (MRAC) as part of a suite of reforms into the funding model for non-face-to-face care under Medicare.
Others included re-establishing funding for specialist subsequent consultations over the phone and inserting an official statement of ‘telehealth principles’ into the MBS to guide doctors.
But while the changes may appear only administrative in scope, the effect would be to limit patient access and cause confusion among providers by contradicting Medical Board of Australia guidance, according to the authors of a recently-published paper.
“These recommendations particularly underestimate the role of telehealth in rural and remote Australia and did not take into account high patient satisfaction with telehealth assessment and treatment during the ongoing coronavirus disease 2019 (COVID-19) pandemic,” they write in Australian Health Review (link here).
The authors, led by psychiatrist and ANU academic Associate Professor Jeffrey Looi, describe the proposed statement of principles as particularly egregious, pointing out no similar guidelines are articulated for telehealth items claimed by allied health practitioners, nor indeed for any other section of the MBS.
Moreover, the recommendation to cease reimbursement for all initial consultations by non-GP specialists would have a significant detrimental impact on patient access, the authors argue.
“This recommendation runs against the substantive evidence-base for rural and remote telehealth effectiveness in Australia, especially during the COVID-19 pandemic, with substantive evidence of patient satisfaction with telehealth-mediated care,” they write.
“The effectiveness of telehealth consultations has been demonstrated across a range of medical specialties, including, but not limited to, pre- and post- operative assessment in surgery and in mental healthcare.”