By amending the previously existing Medicare law on telehealth services, the government aims to make available telehealth consultations and services to every citizen while bulk billed by Medicare. Starting from March 30, the Australian government implemented a ‘whole population’ telehealth system for its citizens.
Therefore every Australian now has free access to telehealth services, and they can consult GPs and other specialists at virtually no immediate cost.
The news has met too many positive remarks, many GPs and health experts applauding the government’s decision regarding the issue. While some consider it the most significant change in recent times, others call it a welcome response to the outcry for better procedures for handling the current pandemic issue.
Initially, the Royal Australian College of General Practitioners and many other medical caregivers and patient groups have clamoured for the Federal Government to arrange an effective response to the COVID-19 crisis.
The result is a $1.1 billion funding package meant to combat the widespread effects of the pandemic. According to Prime Minister Scott Morison, a total of 669 million dollars out of the funding is allocated to telehealth services.
The new Medicare bulk billed telehealth system is expected to be under operation until September 30. All Australian citizens are free to use the service for their healthcare needs until then.
Australia joins the UK and United States as one of the countries to expand telehealth services in light of the current coronavirus pandemic. According to Mr Morrison, the Medicare-subsidized telehealth services ensure that every person can access quality healthcare while staying at home.
What Is Telehealth?
Telehealth, sometimes also referred to as telemedicine and telecare, is the use of ICT to deliver health information and services. This varies from phone consultations to email and video-conferencing.
Using an audio link or visual screen, patients can have a virtual appointment with GPs, mental health experts, specialists, and other health professionals. Applications like Zoom, Skype, WhatsApp, or FaceTime, help a patient discuss health issues and receive medical advice from his consultant.
Telehealth services are not new to Australia. For years, Australians have been employing to deliver medical services and care to rural and regional Australians. Many people in remote areas also use the service from time to time. Telehealth services are available to anyone with a good phone, internet, and payment.
In the year 2011, the Government of Australia introduced the telehealth initiative. Its goal was to deal with the obstacles surrounding access to medical services for areas that were eligible for telehealth.
However, the initiative came with certain restrictions as only patients aged 70 and above had access to the bulk-billed service. It also excluded certain medical professionals services, including GPs, occupational therapists, clinic nurse coordinators, psychologists, and many others.
With the funding and new changes to the law came a lot of improvements. The eligibility criteria have now been expanded to a wider array of medical professionals. Also, now, every person in the country has been granted access to the system.
Of course, this is not the first time the Australian government has expanded telemedicine services. In 2019, the Minister for Health, Greg Hunt, announced a $45.5million investment in GP telehealth consultations.
The purpose of the expansion was to ensure patients in remote areas gain access to regular health consultations with their GPs. The service also stretched for two years, with MBS rebates available.
Due to the potency of the coronavirus and its variants to spread, we need to look for safer ways and tools to care for visiting patients. With the implementation of the “whole population” system, doctors can now test patients for COVID-19 and treat symptoms remotely. This reduces the risk of infection for health workers and possible further spread of the virus.
Eligibility for Medicare
A wide array of appointments is available for both patients and specialists under the new bulk-billed telehealth system. As it stands, people can get access to professionals including:
- General Practitioners
- Psychiatrists
- Pediatricians
- Psychologists
- Occupational therapists for children’s services with developmental delays
- Speech pathologists
- Physiotherapists
- Social workers and dieticians
- Aboriginal and Torres Strait Islander Health Practitioners
- Midwives
- Nurses
To be eligible, a patient must be in Australia and eligible for Medicare. They must also not be admitted to a hospital. Anybody under home quarantine is qualified for the bulk-billed services, most especially, patients more susceptible to coronavirus.
This includes people over 50, people with chronic conditions, pregnant women, and parents with newborns, people with immunocompromised systems and indigenous people over 50.
Currently, the Medicare bulk-billing service has focused on responding to the COVID-19 emergency. People with no current symptoms of the virus may only contact a professional they have seen face-to-face in the past 12 months so that their appointments to be bulk billed.
There are other ways for patients to access regular telehealth services, including networked programs that use broadband internet networks to connect remote clinics with main health facilities.
It is also possible to monitor these programs at home through phone or internet connections. Health workers can also use store-and-forward platforms to disperse patient data securely. Health tracking tools and real-time video links can also be employed, allowing interactions between doctors and patients.
Benefits
The Medicare Bulk Billed Telehealth service primarily reduces the chances of infection for both patients. Instead of sitting around in waiting rooms, risking the chances of contracting the virus, patients can now access medical services remotely from home.
The expansion also ensures all Australians gain access to necessary medical attention whenever needed while in quarantine. Plus, it eases access to other services such as therapies and prescriptions.
The patient simply dials in; the doctor makes a checkup and emails or texts the prescriptions at the end of the session. And all these can be done at virtually zero-pocket costs to the patients.
Medical practitioners, especially front-line health workers, also benefit from this change in the law. As they stand the highest chances of getting infected, it helps to know they can now render services from a safe distance.
The older medical practitioners and those with chronic illnesses benefit most from this development as they’re more susceptible to the virus. Plus, it reduces the stress of moving about to tend to their clients in their old age.
With the new system, medical professionals can carry about their duties while themselves staying in isolation. The new system also ensures scarce protective gear is duly conserved since it won’t be needed during an online consultation.
The Australian Medical Association (AMA) and the RACGP have been calling for the safety of health workers during the pandemic, thus, it is already considered a huge win for the medical community. The president of the AMA, Dr Tony Bartone commended the expansion and considers it a major breakthrough.
Drawbacks
While many doctors and GPs have appraised the current Medicare Bulk Billed Telehealth service, there are some expressed concerns. One angle is the utilization. Although having mentioned the benefits, the Health Minister stressed that a large proportion of GP services require face-to-face treatment.
For those, the Australian College for Emergency Medicine president, Dr John Bonning speaks up. He reminds patients that physical appointments are still a necessity and primary health centres are still open for business.
Also, the bulk billing services translate into reduced cash flow, which means doctors and GPs will get paid less. Thus, to ease the problems of lesser inflow revenue, the FG also stipulates specific incentives for GPs and other practitioners who bulk bill.
Doctors offering telehealth appointments will be paid $6.4 per consult in major cities. Everywhere else, doctors get a total of $9.65. However, only consults to patients below 16 and concession cardholders are eligible for incentives.
There are also reports that the newly implemented system may be further worsening the march to collapse smaller, doctor-owned medical practices. Many small clinics owned by doctors have reported a gradual shortage of patient patronage due to the lockdown and claim that the bulk billing services will cause further revenue loss.
Some GPs point out that at the current pace, the combined problems will force many of these doctor-owned clinics to close down completely. In response, the Health Minister, RACGP, and other medical bodies have called upon Australians not to neglect their health needs. They insist people should seek their doctors and GPs on their routine medical issues.
References
https://www.medicare.gov/coverage/telehealth
https://www.cms.gov/files/document/mln901705-telehealth-services.pdf