What’s really happening with the MBS changes

If you’re feeling a bit overwhelmed by all the Medicare Benefits Schedule (MBS) changes coming our way, you’re not alone. This year has been a whirlwind of reforms, and it’s challenging to keep up with what’s actually happening versus what we’re told is happening. Let’s break down what’s really going on, and what it means for your practice.

Those chronic disease changes hit hard

The chronic disease item changes rolled out in July made things simpler on paper, but they’ve also made a significant dent in practice revenue. Many of us are still trying to figure out how to make the numbers work, while maintaining the same level of care for our patients. The irony isn’t lost on anyone: streamlined processes that actually make it harder to maintain financial sustainability. It’s forced many practices to get creative with how they operate, and we’re all learning to adapt to reduced income streams.

The major change: triple bulk-billing incentive

Here’s the significant change everyone’s talking about, starting 1 November. While this could be transformative, it also has many of us carefully considering our options.

Here’s how it works. Bulk-billing incentives are expanding to all patients, not just children under 16 and concession card holders. That’s straightforward and long overdue. But then there’s the Bulk Billing Practice Incentive Program (BBPIP), which is where it gets complex. Sign up, and you’ll receive an extra 12.5% on eligible services, split equally between GP and practice. Sounds attractive, right?

Here’s the commitment required: it’s all or nothing. You must bulk bill every single eligible service for every Medicare-eligible patient. No exceptions. So, you’re either fully committed or you’re out completely. It’s a significant decision that could completely reshape how you operate. Some see the financial opportunity; others worry about losing billing flexibility. What direction is your practice considering?

Mental health changes getting less attention

While everyone’s focused on the bulk-billing changes, there are mental health item changes that deserve more attention. From 1 November, mental health consultation items 2712 and 2713 are being discontinued. And mental health plan reviews will be part of your regular consultation, billed based on time. This should reduce Medicare rejections, which is positive. However, I can already see potential
issues emerging.

How often do patients book a “quick review” that becomes a 30-minute session? Without specific mental health items, patients might not understand they need longer appointments. We’ll need to do better at explaining this upfront, or we’ll all be running behind schedule. We still don’t have the new item descriptors, so we’re working with incomplete information at this stage.

Level E consultations provide recognition

This is positive news, among all the other changes – finally some recognition for those complex, time-intensive appointments we all manage.

Pharmacy prescribing raises concerns

The initiative the Cook Government announced earlier this year – 17 conditions that pharmacists can now diagnose and treat. As GPs, we understand how fragmented care can lead to missed diagnoses and delayed treatment. We’ve seen this pattern before. The pilot program is proceeding, regardless of our concerns. Fortunately, the AMA (WA) is ensuring our perspectives are heard in the working groups. We’re advocating strongly for continuity of care and ensuring patient safety remains the priority. We often end up managing the complications when care becomes fragmented, so we need to keep advocating for our patients.

Moving forward

These are probably the most significant changes we’ve seen in recent years. Some practices will adapt well; others will face challenges; and most of us will find ways to work through the transition as we always do. It’s important to stay informed and avoid hasty decisions. Whether it’s considering the bulk-billing program or preparing for the mental health changes, take time to think through what works for your practice and your patients.

We’re all navigating this together, and the AMA (WA) will continue advocating for what’s best for both GPs and patients. The changes are significant – but with careful planning and adaptation, we’ll manage the transition successfully.