The RACP has added its voice to calls for a return to full Medicare funding of all phone and video specialist consultations, declaring it should be up to doctors and their patients to decide how they want to interact.

The college has also made the case for Medicare incentives to encourage physicians to relocate outside the major cities and cash for rural specialist training hubs to tackle workforce shortages, in a pre-budget submission to the federal government.

It comes as the federal government considers further reforms to MBS telehealth funding, including recommendations to delete the items for initial specialist consultations.

The recommendation was put forward late last year by the MBS Review Advisory Committee 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.

Now the RACP has had its say, arguing for a “full range of initial, subsequent and complex MBS video and telephone-based specialist items on a permanent basis”.

This should be funded via new, permanent Medicare items as well as Practice Incentive Payments covering all consultant physicians to promote uptake of telehealth models of care and the delivery of integrated care.

Such a change would “improve telehealth services, reduce the digital divide and promote equitable access to healthcare”, the submission states (link here).

“Both video and telephone modalities have been shown to generally reduce preventable mortality and hospitalisation and support routine care while significantly cutting down travel and associated costs, appointment waiting times and transport barriers to in-person attendance,” it says.

“The most appropriate modality (whether face-to-face, video or telephone) should thus be negotiated between the practitioner and the patient, considering their individual and specific clinical needs and circumstances.”

Workforce reform

More Specialist Training Program in rural and regional communities are another priority, with the college also arguing for an increase in incentives and improved flexibility in medical specialty variations in the recently-introduced rural training requirements.

Beyond that, the college says it should be allowed to utilise salary support funding under the program to pay for additional posts in areas of need.

As for rural Medicare incentives, the college does not specify how these should work, but says MBS payments should be introduced “to encourage physicians to relocate and remain in rural, regional and remote practice locations.”

Also on the wish list is:

• A broader role for the newly-established Australian Centre for Disease Control (CDC)
• Increased funding for bariatric surgeries and PBS subsidies for evidence-based pharmacotherapies for obesity
• An MBS item number to allow physicians to engage employers, supervisors, workplace regulators and unions to assess hazards that may be work, health and safety issues.

More broadly, the RACP wants action on carbon emissions, preventative health, as well as disability and aged care.

“The RACP and its members are committed to supporting the Australian Government in addressing the growing challenges that impact our patients, our communities, our health system and our natural environments,” it says.

“Our members believe that the recommendations outlined in this submission will improve health outcomes for Australians, reduce the growing pressure on the health system and assist in progressing the reform agenda of the Australian Government.”