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Doctors hit by incentive cuts, tighter rules as Budget redirects priorities

Doctors face cuts to incentive payments and stringent funding rules as the Federal Government seeks to claw back spending in much of the health portfolio and redirect it to priority areas including e-health. In a move that could cost some practitioners up to $4500 as well as undermining an important preventive health measure, the Government has scrapped the GP Immunisation Incentives Scheme as part of a range of controversial changes to the Practice Incentives Program expected to save $83.5 million over the next four years.

09 May 2012

Doctors face cuts to incentive payments and stringent funding rules as the Federal Government seeks to claw back spending in much of the health portfolio and redirect it to priority areas including e-health.

In a move that could cost some practitioners up to $4500 as well as undermining an important preventive health measure, the Government has scrapped the GP Immunisation Incentives Scheme as part of a range of controversial changes to the Practice Incentives Program expected to save $83.5 million over the next four years.

Not only will GPs lose incentive payments for ensuring more than 90 per cent of their child patients are fully immunised, they face more stringent tratment targets under the program, including ensuring 70 per cent of eligible female patients are given pap smears – a 5 percentage point increase – and preparing care plans for at least 50 per cent of diabetic patients, up from 40 per cent.

The Government has also dealt a double-blow to doctors over the introduction of its personally controlled electronic health record (PCEHR) scheme.

Not only did the Budget fail to address AMA concerns about the lack of a rebate to cover the costs incurred by practitioners in helping create and maintain electronic health records, but practices will lose access to an incentives package worth up to $50,000 a year if they do not participate in the PCEHR scheme.

Adding to the pain for doctors, the Budget detailed major changes to the Government’s telehealth initiative, including scrapping the Telehealth Support Initiative from July next year and withdrawing telehealth incentive payments from mid-2014.

Telehealth is also one of the areas where there will be a crackdown on rorting by some practitioners.

The Government will require that telehealth consultations must be conducted over a distance of at least 15 kilometres to be eligible for rebate.

The telehealth incentive cuts and tighter eligibility criteria are predicted to save almost $184 million over the next five years, money the Government says will be redirected into its e-health program.

In the Budget the Government has allocated an extra $234 million to continue the rollout of the e-health system, including almost $162 million to operate the PCEHR scheme during the next two years, more than $67 million for the National E-Health Transition Authority to “maintain critical services and standards” and $4.6 million to sustain privacy safeguards.

Other savings

The Government intends to crack down on what it sees as rorts of the Medicare system, particularly the Extended Medicare Safety Net (EMSN), which reimburses 80 per cent of a patients’s out-of-pocket expenses incurred for services provided outside hospital, once spending passes $1200 a year.

In a measure expected to save $96.5 million in the next four years, the Government will cap EMSN benefits for all consultation items and “a range” of procedures, including “those where excessive fees are being charged, where there has been excessive growth in EMSN benefits, where the EMSN is being used to subsidise items that could be used for cosmetic pruposes and where there is a risk that practitioners will shift excessive fees onto other items, such as consultation items”.

The Government also expects to make savings by axeing the rebate for some hyperbaric oxygen therapy procedures, cracking down on private health rebates for natual therapies and tightening spending on diagnostic radiology.

AR


Published: 09 May 2012