MBS Review - NP Group Recommendations

MBS Update - 28/4/20

The ACNP has been in regular communications with the Chair of the MBS Taskforce Prof. Bruce Robinson over the course of the MBS review.  Today we received an update, it is important that you are all aware that the Taskforce is still working towards an outcome by 30 June 2020.  

Prof Robinson did previously notify us that the planned meeting of the Taskforce scheduled for earlier this month was postponed due to COVID 19.  Today he let us know that despite the fact that many of the Taskforce members are clinicians, supporting front-line work in response to COVID-19, they still are committed to the June 30 timeline.

We will provide further updates should anything arise.

Background

The Medicare Benefits Schedule Review Taskforce Report from the Nurse Practitioner Reference Group (NPRG) has been released, with 14 detailed recommendations.  This report will now be considered by the MBS Taskforce, and released to Stakeholder consultation, which includes the ACNP.  Following that, the taskforce can make recommendations to the Minister. 

What we hope to achieve from the current MBS review is significant increase in access to Nurse Practitioners services for the Australian public.  This will assist the development of more roles in the Private sector, and more Nurse Practitioners will be able to work towards addressing the gaps in health services, and the health of our community.

The ACNP is pleased that the changes outlines within the 14 recommendations will also lead to significant growth in Nurse Practitioner numbers in Australia, especially in areas of need, and a more sustainable workforce.  The ACNP has been heartened by the large number of responses to our sharing of the "MBS Report from the NP Reference Group". 

 

You can access the full report from the MBS Review - NP Reference Group by clicking on the link below. 

MBSReferenceGroup

 

You can read about the Scope of Practice of a Nurse Practitioner by clicking on the link below. 

ScopeofPractice

 

Relevant Documents

Cost Benefit Analysis of Nurse Practitioner Models of Care Report from KPMG

Executive Summary

KPMG was engaged to conduct a cost benefit analysis (CBA) of Nurse Practitioner (NP) models of care in the aged care and primary health care sectors in Australia in order to identify key success factors and challenges as well as areas for potential expansion.

The NP role has emerged as a way to expand the scope of practice for nurses in order to improve access to healthcare, particularly for remote, marginalised and vulnerable populations. The ability for NPs to work both independently and collaboratively within a multidisciplinary health team, and their ability to undertake advanced clinical care, positions the role to provide flexible and affordable health services to Australian communities.

 

CostBenefitAnalysis

 

ACNP Response - MBS Review Taskforce - Report from the NPRG

Executive Summary

The Australian College of Nurse Practitioners (ACNP) fully supports each of the recommendations proposed by the Nurse Practitioner Reference Group (NPRG) 2018 as part of the Medicare Benefits Schedule (MBS) Review.

The fourteen recommendations serve to improve the accessibility and availability of quality health care for Australian people, especially those in underserved and marginalised communities. The recommendations also create greater flexibility and choice for people, enabling them to access safe and high-quality healthcare delivered in the right place, at the right time.

The current constraints of the MBS items and existing legislation contribute to fragmentation of care and unnecessary duplication of services, which negatively impacts on people, as well as healthcare expenditure. Implementation of these recommendations will allow nurse practitioners to navigate and provide quality care to people to the full extent of their scope of practice, improving access to care and affordability of services, without unnecessary constraints. Adoption by the Government of the fourteen recommendations proposed by the NRPG (2018) will provide nurse practitioner services greater flexibility to provide services to Australian communities, particularly marginalised and traditionally underserved populations. These recommendations will also significantly reduce the unnecessary duplication that the current arrangements create within the MBS.

 

ACNPResponse

 

 

Ongoing Updates

“With the MBS Review still underway the ACNP would like to reassure all of you that we are still actively engaged in this process, while also working on the current COVID-19 Telehealth MBS items, and the response to COVID-19. 

The ACNP will continue to work with the Government towards the best outcome that improves access to care for the community, and is sustainable for Nurse Practitioners.  We understand that this is taking longer than anticipated and it is enormously trying for us all, but we need to remain determined, united and strong-minded. While all 14 recommendations of the NPRG would no doubt assist during the pandemic, we must prioritise the key items needed urgently to maximise patient access to care.  The safety of the Australian community remains paramount and we will continue to keep members updated of the progress in this area."

Leanne Boase, ACNP President

DECEMBER 2019  

UpdateMBSTaskforce

 

At the end of November ACNP President, Leanne Boase wrote to Prof. Bruce Robinson and The Hon. Greg Hunt to request an urgent update on the progress of the MBS review - Final Report of the Nurse Practitioner Reference Group (NPRG).  We had been expecting an outcome in November.

The ACNP received a prompt response from Prof. Bruce Robinson, Chair of the Medicare Benefits Schedule Review Taskforce. 

The ACNP has been advised that a Taskforce meeting will be held on the 11th & 12th December, 2019, where the recommendations from all of the Primary Care Reference Groups (including the NPRG) are being considered.  It is possible that we may receive an update following this meeting, and we will advise members ASAP.

Please be assured that the ACNP is continuing to communicate with key stakeholders, and support the recommendations of the NPRG.  These recommendations are based on extensive evidence, and will significantly improve access to nurse practitioner services, address gaps in health service delivery, and improve the health of the community.

We will keep members updated of the progress. 

Dr Richard Di Natake's letter to Greg Hunt, Health Minister (dated 6/12/2019)

Letter from Greg Hunt Health Minister, received 9/12/2019

MBS Review September 2019 Federal Department of Health

 

SEPTEMBER 2019  

The aim is to write to your own Federal MP, Senator, and also the Health Minister, the Hon Greg Hunt.  If you wish to write to more Federal MPs in your area, that would be beneficial.

In order to have maximum impact, we recommend making changes to the template, while sticking with positive messages and the main themes already included.

Remember to keep it positive and patient focussed.  You can use the prompts in the template, and also make changes to it to individualise your response.

We have created a letter template (below) and included the steps and tips to streamline this process for you below:

 

Templates

ACNP Member Letter Template Oct 2019

Member Guide updated Oct 2019

Please contact the ACNP on 1300 433 660 if you need any assistance.

MAY 2019

As the closing date of June 7, 2019 approaches your College is reaching out to other individuals and bodies to encourage them to provide feedback.  You can see further down the page those who have already expressed their support.  Here is the ACNP Letter to Stakeholders NPRG for written submission that has been distributed.

To offer your support you can send a submission of your own to the Medicare Benefits Schedule Review Taskforce, Professor Tim Usherwood, Chair – General Practice and Primary Care Clinical Committee.  If you are not sure what to write, ACNP has a NPRG Submission Template For Members to build on. 

WE ASK OUR MEMBERS TO CONSIDER THE FOLLOWING MAIN PRINCIPLES OF THE ACNP RESPONSE, INCLUDING FOCUS ON:

  • Benefits to patients - the patient comes first
  • Improvement of access to care - not all needs are being met in our community
  • Nurses, including Nurse Practitioners, can deliver better health care in more places if enabled to work to full scope of practice
  • Nurse Practitioners focus on preventative care and health education, as well as managing acute or chronic illness, and are therefore economically sustainable, and excellent value for the taxpayer dollar

The College is not responding to negative media, or statements that are not supported by evidence.  We will instead focus on the added value we bring to the Australian Health care system and our community, and engaging with key stakeholders to support the 14 recommendations.  

If members would like to complete an individual submission, you can choose to focus on any, or all of the recommendations, or the general principles as above.

APRIL 2019

On the 27th March the ACNP attended the Stakeholder Consultation relating to the Medicare Benefits Schedule (MBS) Review Taskforce – Report from the Nurse Practitioner Health Reference Group.

In attendance representing ACNP and our members were Catherine Smith, Amanda Davies and Leanne Boase.

Each of the recommendations were discussed with Taskforce and NPRG members, other nursing stakeholders, and consumer representatives.  We were very well supported by the other attendees at the Stakeholder consultation.

We clearly expressed strong support for each of the 14 recommendations in the Report, highlighting case examples and the evidence to support them.  We will continue with our working groups to ensure we are well prepared for our written response.  Thank-you to all of our members that helped us to prepare.

Additional Information

Useful Links

The Terms of reference, membership of the Taskforce and reports of the Medicare Benefits Schedule (MBS) Review Taskforce are available at: 

http://www.health.gov.au/internet/main/publishing.nsf/Content/MBSR-about

To find out more about 'Eligible Nurse Practitioners Questions and Answers' you can go to: 

http://www.health.gov.au/internet/main/publishing.nsf/Content/midwives-nurse-pract-qanda-nursepract#3.

The ACNP would like to sincerely thank the over 200 members who contributed to this submission, there are far too many to name, but we are immensely pleased with the response and engagement we have had, and we look forward to the outcome, knowing that we have truly represented the interests of the community first and foremost.  Leanne Boase

View the ACNP MBS Review Media Release

Please click below to listen to radio interviews conducted with ACNP President, Leanne Boase:

Please click below to watch the TV interview conducted by WIN News Gippsland with ACNP President, Leanne Boase:

A letter was sent to the Prime Minister, the Hon Scott Morrison MP, requesting support.  Reply was received  via Letter from The Hon Steve Irons MP.

We have been in contact with the Honourable, Greg Hunt, MP, Federal Health Minister, via mail.  You can read our comments in the Letter to Minister Hunt.

The ACNP MBS Review survey was sent to all members and your College obtain deidentified case studies and valuable feedback.  Thank you to the many members who took time to complete the Survey.  We were thrilled and overwhelmed with more than 150 replies.  As a result of the informed and detailed replies your Board has set up 10 working parties to fully address the 14 recommendations.  The working parties were:

Recommendation 1 & 2 Working Group
Recommendation 1: Enable patients to access MBS rebates for long-term and primary care management provided by NPs
Recommendation 2: Improve access to MBS-subsidised NP services in aged care settings
Lead: Stephanie Dowden WAChapter@acnp.org.au

Recommendation 3 Working Group
Recommendation 3: Enable DMMRs and RMMRs to be initiated by NPs 

Lead: Melanie Proper QLDChapter@acnp.org.au

Recommendation 4 Working Group
Recommendation 4: Significantly increase the schedule fee assigned to current MBS NP professional attendance items

Lead: Catherine Smith (catherine.smith@acnp.org.au)

Recommendation 5 Working Group
Recommendation 5: Longer NP attendances to support the delivery of complex and comprehensive care
Lead: Verena Tinning (NTChapter@acnp.org.au)

Recommendation 6 Working Group

Recommendation 6: Enable patients to access MBS rebates for after-hours or emergency care provided by NPs

Lead: Juliane Samara ACTChapter@acnp.org.au

Recommendation 7 Working Group
Recommendation 7: Enable patients to access MBS rebates for NP care received outside of a clinic setting

Lead: Hazel Bucher hazel.bucher@acnp.org.au

Recommendation 8 Working Group

Recommendation 8 – Remove the mandated requirement for NPs to form collaborative arrangements
Lead: Leanne Boase (leanne.boase@acnp.org.au)

Recommendation 9 Working Group

Recommendation 9: Remove current restrictions on diagnostic imaging investigations when requested by NPs

Lead: Debra Earl SAChapter@acnp.org.au

Recommendation 10 Working Group
Recommendation 10: Enable patients to access MBS rebates for procedures performed by an NP

Lead: Kerrie Duggan TASChapter@acnp.org.au  

Recommendation 11-14 Working Group

Recommendation 11: Add GPs as eligible participants in NP patient-side telehealth services

Recommendation 12: Add patients in community aged care settings to residential aged care telehealth items

Recommendation 13: Create new MBS items for direct NP-to-patient telehealth consultations

Recommendation 14: Allow telehealth consultations to take place via telephone where clinically appropriate
Leads: Melissa Robinson Reilly nswchapter@acnp.org.au and Amanda Davies amanda.davies@acnp.org.au

 

 

 

Letters Of Support

The ACNP is pleased to acknowledge the support of the following organisations who are equally encouraged by the recommendations and their positive improvement to better health outcomes for all Australians, including the Aged Care sector and Rural and Remote areas.