A prominent Perth pathologist has warned changes to bulk billing rates for pathology services coming into place next month would mean bulk billing as a rule rather than the exception will come to an end.
Pathologist and AMA (WA) President Dr Michael Page told Medical Forum that if rebates for pathology services were not raised soon, operators would have little choice but to increasingly implement out-of-pocket charges.
While the first indexation of pathology services that has occurred in Australia in 25 years is set to come into play in July, Dr Page, who is also the chief executive of Clinipath Pathology, said it did not go far enough as it only covers about a third of all pathology items.
A Department of Health and Aged Care factsheet states: “Medicare Benefits Schedule (MBS) items for certain pathology services – those in the Haematology (P1), Immunology (P4), Tissue Pathology (P5), Cytology (P6) and Infertility & Pregnancy (P8) service groups – will have their fees indexed annually.”
It noted the indexation was occurring in response to pathology provider concern in regard to reaching the limit of their efficiencies.
Dr Page described the impact of the planned indexation as “minor”.
“It is only on part of the fee schedule and with that, they announced that they were going to cut rebates on a couple of really key tests, including vitamin B12 and some urine tests,” he said.
“Despite significant inflation and increase in overheads in that time, pathology rebates have fallen behind every other part of the Medicare fee schedule.”
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He added that while automation of processes and consolidation of operators had brought some costs down, other costs such as staffing, rent and electricity had gone up.
While out-of-pocket costs had become the norm for things such as prescription medicine, GP visits and specialist appointments, most pathology services have not had to implement fees.
“The Federal Government is cutting rebates on tests to levels that are not sustainable for pathology practices to simply absorb the hit, that means that we will have to put out-of-pocket costs on some tests,” Dr Page said.
He said if that occurs there would be a risk that people would skip pathology testing because of the costs involved.
“If people choose not to get their testing done, it means their health conditions, diabetes, whatever it might be, will go unmonitored or undiagnosed in the first place and that will undoubtedly lead to poorer health outcomes.
“The business model as it is, is unsustainable with the Medicare rebates that we’re receiving.”
The national peak body for private pathology Pathology Australia, which has argued the indexation of pathology services will cover just one third of pathology items, has been running a campaign to Keep Pathology Bulk Billed.
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In a radio interview in May, Health Minister Mark Butler described the campaign as “pretty dishonest”.
“We implemented some changes that were the product of expert advice, expert clinical advice,” he said.
“There is a sort of expert group of doctors and clinicians who advise the government, whether they’re Labor or Liberal, about how the Medicare schedule works, and they provided some advice to try and cut down what they describe as unnecessary tests.
“They try to suggest that these changes are political changes when in actual fact what they are is implementing the best advice we have from doctors about how to use the Medicare system.”
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