Consumers need strong say in Medicare review

The Medicare Review interim report underlines the need for reform of Medicare and for there to be strong input from consumers as well as health professionals, the Consumer Health Forum says.

“This review is the most important, wide-ranging examination of Medicare since its establishment 32 years ago.  The taskforce report released today makes the case for change clear if we are to have a public health insurance scheme that results in the provision of high value care to patients and meets contemporary realities, like the rise in chronic illness,”  the CEO of the Consumers Health Forum, Leanne Wells, said.

“The Consumers Health Forum has urged the Government to review Medicare to ensure Australia is getting best value from the health services.  The identification by the review of ‘low value’ Medicare services should free up expenditure for use in areas of need, using new ways of paying for clinical care such as Health Care Homes provision of integrated care for those with chronic and complex conditions.

“The Consumers Health Forum has also made it clear to the Government and the Taskforce that in order to get a strong consumer focus in this important review there needs to be well-resourced and independent public input to ensure that the patient’s perspective is uppermost.

“The interim report lays out a plan for the future work program of the review.  The review has made a decision to be ambitious in its approach and seize this unique opportunity to recommend changes to modernise Medicare on all levels, from the clinical detail and relevance of individual items, to administrative rules to structural, whole-of-MBS issues. This is all the more reason for consumer insights and advice to be integral.      

“CHF has been pleased to be engaged to provide advice on the best way to engage consumers throughout the review.  Our concern however, is that the review process has been going ahead without adequate and robust input from consumers. 

“Now that the review has commenced a rolling program of clinical committees to examine all Medicare items, there needs to be effective and systemic ways for consumers – those with most at stake - to provide meaningful input adding to those from clinician representatives.   

 “The evidence is strong that we get better health outcomes when patients and consumers are engaged in decisions about health services.  This goes beyond a single consumer representative on a committee to strategies such as those recommended by CHF, including:

  • The availability of clear, plain English and transparent information about the review process itself and how the public can meaningfully participate
  • A dedicated website to support public involvement 
  • The appointment of a public involvement adviser for each clinical committee.
  •  Familiarisation education, training and support for consumer advisers to the review and its various committees.  

“The report states that the potential value of MBS data and other information to consumers is ‘not being fully exploited’. Better access to data may assist consumers both in accessing care in the first instance, and also making decisions about their subsequent care. In particular, the Taskforce notes that there is support for improving information to patients about fees charged by healthcare providers,” Ms Wells said.

“We welcome the directions the review has said it will take in areas such as:

  • Greater transparency, yielding better and more readily available information on Medicare items and data that would assist consumers in making decisions about accessing services, including greater fee transparency.
  • Exploring opportunities to complement fee-for-service Medicare with other payment elements, such as those linked to outcomes, and reflecting integrated care processes.


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Jenna Gray

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