Saturday, May 23, 2009

Medicare

I’d like to open a discussion on Medicare.
First a little background! As of 1 November 2006 allied mental health Medicare items became available on the Medicare Benefits Schedule. Medicare rebates are available, on referral for up to 12 individual allied mental health services per patient per calendar year, generally provided in up to two groups of up to 6 services with the referring practitioner considering the need for further sessions after a course of treatment (which may comprise up to 6 services).
Allied mental health services that can be provided under this initiative include Psychological Therapy services provided by eligible clinical psychologists and Focussed Psychological Strategies services provided by eligible psychologists, social workers and occupational therapists. This program is called “Better Access to Mental Health”.
At Richardson Support House we have a psychologist and a social worker. When we started Richardson Support House, we were keen to offer affordable and accessible counselling services to those in need. As such, we have become Medicare providers (Allied Health), providing services as described above.
Now all of this is not without controversy (both Nationally and at our local level).
First, the Better Access to Mental Health program has been far more popular than the Federal Government anticipated. This year the figures have increased even further (The Australian reported it might be due to current financial stress, May 2009). You can view the figures at www.health.gov.au/internet/mental health/publishing.nsf/Content/mental-ba-fig
Various concerns have been raised: Although collaboration between GP and Allied Health providers is encouraged, there is no monitoring or accountability to ensure this happens. There are no incentives for “co-location of services, effective geographical distribution of services, provision of early interventions for young people, or treatment of patients in greatest need at low cost” (The Australian, 19 May 2009). Some experts are concerned that people benefiting from the program are those already receiving treatment and who can afford large gap payments.
At our local level, Richardson Support House bulk bills patients with Health Care Cards or under 16 years. For other patients the payment gap varies depending on the type of service, but it is never more than $5. It has been said that we are setting our prices too low, that services will be undervalued to the detriment of both the service and other providers.
Well, we are pretty gung ho about our desire to have an “accessible and affordable” service. We accept various people’s concerns, and to some degree we can address those issues. We do want to ensure that we are open to collaboration with the referring Doctors and other mental health providers. We do wish to encourage those most in need to access our services. (Partly I think the onus is on us to promote the service locally). I realise that we can’t satisfy everyone’s concerns, nor can we have “all the people happy all the time”! But if we can just reach some people in need, then we’ll have achieved all we hoped for.

We've been operating for about 10 months now. Some of the patients are those "already accessing services". But some patients have had long term issues they have never before sought treatment for.

I’d really like to hear from others about their opinions on the new Medicare program?

7 comments:

Michael Campbell said...

I think the new Medicare system is a good step in the right direction.

It's comforting to see people coming in who haven't been able to afford help previously.

Yes, there are a few bugs to be ironed out (like the current lack of inter-service co-operation and accountability), but I don't feel that these negate the gains to be had.

They can always write more into the system to make it operate more "as intended" if the Government bodies feel it isn't stacking up.

Anonymous said...

I really wanted to get some help for my child, so I approached the GP for a mental health plan. The GP had a lot of comments which I wanted to share with you. The GP said at first that only some GPs could do it. I said that was true previously, but there was a new Medicare program where any GP could submit the plan. Then they said it would take too long and they wouldn't be paid for it. Luckily I had the Medicare information brochure from Beyond Blue with me, and I was able to show them that they do get paid for it, and I had booked a double appointment so there would be enough time. Then the GP cautioned me that it would be on permanent government record, and there could be trouble later on if my child wanted to join the Police or the Military. I don't know anything about this - is that true? Finally the GP said that Psychologists and Social Workers charge a large gap over medicare and it could sometimes be difficult to afford. So I was happy to say that I could go to Richardson Support House and be bulk billed.
So it's great that this program exists, but I think it can sometimes be very difficult to get the referral from the GP.

Anonymous said...

I also asked my GP for a 2710 and they refused.

Anonymous said...

I have had several dealing with medicare and the doctors who are supposed to give help to the people who need it. These people are very upset and in need of help. With richardson support houses help. it was great to be able to go to the doctor and ask for the right form and recommend your services to anyone who is willing and able to listen. Keep up the great effort. well done there should be more peolple out there like all of you there. Thanks

Anonymous said...

The initiative itself is great, the lack of support and understanding in some areas (eg some doctors) not so great, and the very high non-bulk billed fees charged by some mental health professionals also not so great. I do have one general concern - in working with people who are at risk of homelessness there is often no one they can call 'their doctor' and as such it is really difficult to get any sort of referral. The same applies to the medicare dental program - people must be referred by their own doctor who knows them. In the city at present there are no doctors who bulk bill, and many have actually closed their lists.

Leonie Cent said...

Hello - I have previously been provided with a Mental Health Care Plan by my GP, so that I could access a psychologist. However, the psychologist I saw was very expensive and I still had to pay around $100 each time - so I only went twice as that was all I could afford (I chose the psych because he specialised in ADHD issues). Maybe it's too much to ask to be able to choose a psych based on personal preference, instead of seeing someone you can afford who may not be right for you. I do realise though, that having access to psychological services is a god-send to many people and helps them greatly. Personally, I do not feel that I'm "above" seeing a psych at Richardson House, for example. I would welcome the opportunity and am happy that such a service exists. I guess I wanted to make the point that it would be nice, in an ideal world ;) if people had more choice when it comes to things like therapy. Thank you and all the best....

Leonie Cent said...

I wanted to add that I know a few doctors who readily help people with Mental Health Plans. One is Dr Esther Hyams-Elijah in O'Connor at the Wattle St Medical Practice 62485446 - my personal doctor who is very nice. Also, Dr Tim Watson at Gungahlin does Mental Health Plans, and his colleagues probably do as well (Gungahlin General Practice 62410888)- (be warned that Dr Tim is a rough and ready type of doc and will try and process you in the shortest time possible - my mental health plan was finished in about 1 minute, instead of 45 minutes which is standard)