A review committee tasked to advise the Australian government on publicly funded services listed on the Medicare Benefits Schedule has released its official recommendations on implementing subsidised telehealth services in the country. 

This comes as many COVID-19-era telehealth items, including assessments for COVID-19 antiviral medication over the phone, are set to expire next month, July. 

FINDINGS

A major recommendation by the MBS Review Advisory Committee (MRAC) is to reintroduce GP telephone services with a known clinician and the option to receive subsequent telephone consultations for continuing care. Telephone consultations are particularly appropriate for GP chronic disease management, it said. 

However, this does not cover assessments for COVID-19 antiviral medication over the phone. The Royal Australian College of General Practitioners reportedly raised this issue to the Health Ministry, stating that COVID-19 infections continue to spread in communities and insisting that such telehealth items "must remain in place for the foreseeable future."

Another recommendation is to retain video telehealth items referring to first or initial consultations with non-GP specialists. 

The MRAC in its draft report last year initially suggested making non-GP specialist MBS items available only face-to-face, which earned opposition from stakeholders such as the Australian Medical Association. "For a number specialties, an initial telehealth consultation can provide an opportunity to arrange necessary diagnostic tests – providing the basis for a much more informed subsequent consultation – often proceeding on a face-to-face basis," the AMA previously said in its comment to the draft report.

The review committee also recommends that GP patient end-support services for non-GP specialist consultations be reinstated and extended to include nurse practitioners. It also wants the patient end-support with a GP to be extended as well to nurse practitioners, allied health, and Aboriginal and Torres Strait Islander Health practitioners. 

Other noteworthy recommendations are to end the MBS telehealth items for nicotine cessation implemented at the start of 2024 and make permanent telehealth items for bloodborne viruses and sexual and reproductive health.

THE LARGER TREND

Before 2020, telehealth was mostly used for non-GP specialist consultations with patients living outside major cities. During the pandemic, temporary MBS telehealth items were introduced to ensure healthcare access amid lockdowns and social distancing mandates. Most of these items, which are backed by A$106 million ($76 million) funding, are now permanent. 

The latest MRAC report noted that telehealth remains largely provided by GPs, making up a fifth of MBS items. Interestingly, they use video telehealth the least, making up 5% of consultations last year. Allied health and non-GP specialists reportedly have the highest uptake of video telehealth, making up 75% and 48% of all telehealth consultations.