Some changes to the Medicare Benefits Schedule for telehealth items in Australia – including the termination of 128 items, amendment of 17 items, and the addition of two more items – have taken effect this week. 

WHAT IT'S ABOUT

The changes come following the recommendations by the MBS Review Taskforce. In a statement, the Department of Health claimed the changes in telehealth items, along with items for COVID-19, bulk billing incentives, surgery and others, will "ensure services are clinically appropriate; reflect modern clinical practice; improve quality of care and safety for patients; and increase access to services".

Among those removed are video telehealth items that were introduced in 2011 for remote areas and specific settings and offered by GPs, medical specialists, midwives and nurse practitioners – except those provided by Aboriginal health workers, practice nurses and optometrists.

The 2002 telepsychiatry items will be replaced by video telehealth items introduced during the COVID-19 pandemic, while inpatient telehealth items introduced in September 2021 will no longer be available. 

Although there are two new extended telephone consultation items for attendances 20 minutes or longer for patients in rural and remote communities, the COVID-19 hotspot telephone items offered by GPs for consultations longer than 20 minutes have been cut. 

To avoid redundancy, superseded pre-COVID telehealth and associated items have been removed from the MBS, including GP and other medical practitioner mental health consultations and general attendances by video. Patient-end support items linked to pre-COVID telehealth services by GPs and other medical practitioners have ended as well. 

Telehealth consultation items for nurse practitioners, midwifery, nursing and other allied health that were offered prior to the pandemic have also closed. 

WHY IT MATTERS

Some healthcare leaders in the country have pointed out potential consequences of the MBS telehealth changes. Fran Boyle, president of the Clinical Oncology Society of Australia, told the Guardian Australia in a recent interview that patients will have a "major problem" with phone consultations that are no longer subsidised by the government. 

A study published in October in the Journal of Telemedicine and Telecare pointed out from a survey that Australian patients prefer telehealth via phone than through videoconferencing, probably due to technical difficulties associated with the latter. 

Australian Medical Association President Dr Omar Khorshid also told the same publication that given the ongoing pandemic, it would be better to extend the availability of the telehealth items instead of cutting them. 

In another Guardian report, psychiatrist Dr Vivienne James of Gordon Clinic in Sydney, raised that it is not financially viable for them to continue seeing patients due to the MBS changes on telepsychiatry and that many mental health patients will be distressed if they would not be able to pay them.

THE LARGER CONTEXT

On 13 December, the Australian government announced a A$106 million ($76 million) budget over four years to make telehealth permanent, ensuring flexibility in healthcare delivery and continuous health consultations via phone or online. It noted that since March 2020, more than 16 million patients have received over 80 million COVID-19 telehealth services under the MBS and around 89,000 providers are now using telehealth services.