The Australian government is investing A$106 million over four years to support permanent telehealth services, but the government has also made some reimbursement changes that many providers are unhappy with.
Noting that telehealth has been transformational to Australia’s universal healthcare during the COVID-19 pandemic, the Australian government now plans to pump A$106 million ($76 million) over four years to support permanent telehealth services.
The Australian government said the investment ensures greater flexibility to patients and doctors for the delivery of healthcare, allowing general practitioners, specialists, and allied health professionals to continue consulting with patients by phone or video conference. The government noted that some services are changing to align with evidence and expert advice (more on that below). This will ensure patients receive high quality and high value telehealth as part of the range of Medicare services they use, the government said.
The Hon Greg Hunt MP, Australia's Minister for Health and Aged Care, calls the investment a "once in a generation change to the way healthcare is accessed by the Australian people." Minister Hunt said telehealth will also continue to improve the level of access to quality care, particularly for those in regional, rural, and remote Australia.
HealthcareITNews reports that more than 16 million patients have received more than 80 million COVID-19 telehealth services under the Medicare Benefits Schedule (MBS) since last March. Around 89,000 providers are now using telehealth services, the report says.
HealthcareITNews also reports that the Australian government's new investment in this space includes A$31.8 million ($22.8 million) for the Workforce Incentive Programme, which will provide additional funding to general practices by adding telehealth items in the calculation of Standard Whole Patient Equivalent.
Ongoing MBS telehealth services are available nationally in Australia. Eligibility for general practitioner telehealth services will continue to require patients to have had a face-to-face consultation with their telehealth provider, or another provider at the same practice, in the 12-months before the telehealth service. There are some limited exceptions to this requirement that will continue for patients who are subject to COVID-19 public health orders and for some specific types of general practitioner services.
Experts Worry About New MBS Telehealth Changes
While the government's increased funding to support permanent telehealth services is obviously a win for Australians, some experts say the recent changes to the MBS for telehealth are not.
Changes to the MBS for telehealth items in Australia include the termination of 128 items, amendment of 17 items, and the addition of two items. Many items appear to replace telephone consultations with video consultations or in-person appointments. Detailed factsheets and resources regarding Medicare telehealth services are available on the Medicare Benefits Schedule (MBS) Online website, outlining the changes that took effect at the start of the year.
A study published in October in the Journal of Telemedicine and Telecare pointed out from a survey that Australian patients prefer telehealth via phone than through videoconferencing, probably due to technical difficulties associated with the latter.
Mental health consultations appear to be heavily impacted by the changes, and The Guardian quotes one Australian psychiatrist, Vivienne James, MD who said she is "devastated" by the changes, and that her patients will be "distressed." Guardian Australia revealed how other changes would affect patients, particularly those with cancer.
Will Other Governments Follow Suit?
It may be too soon to say how the global adoption of telehealth services will impact patients in other parts of the world on a permanent basis, but many industry experts are predicting, and perhaps even crossing their fingers and toes, that the trend does indeed stick around after the pandemic ends. Whenever that might be.
"To cope with restrictions brought on by the pandemic and overcrowded hospitals, many providers turned to telehealth and remote monitoring to limit in-person visits, while ensuring patients still had access to regular healthcare," Antoine Robiliard, vice president at Withings, wrote in an article exclusive to MD+DI. "... Suddenly, years of draconian restrictions on telehealth service were removed, allowing the general public to access healthcare remotely. These moves have helped keep vulnerable patients in their homes and away from virus exposure, while allowing them to continue to receive care for their chronic conditions. They also limited the virus from spreading in the community and protected health professionals."
Robiliard oversees health solutions at Withings, the company’s B2B division that markets solutions dedicated to the healthcare industry.
If our expert predictions for 2022 are correct (and I would say well beyond 2022 in this particular case), technologies like this will indeed continue to transform both the industry and healthcare systems around the world.
"Pre-pandemic . . . there were a lot of conversations about software as a medical device and interoperability and things like that. But what's accelerated digital health technology and digital transformation is the fact that so many stakeholders are now accelerating the technology and their initiatives because of the way we are operating today, much more remotely, whether its telemedicine or patient engagement with physicians," said Joe Sapiente, vice president of clinical science and technology for the Medical Device Innovation Consortium (MDIC), in an online BIOMEDevice session. "It's definitely not a fad, and it's really picked up in terms of pace and timing." The MDIC is exploring the convergence of connectivity, information, and software in its new Digital Health Initiative.
The consortium has several active programs on software as a medical device, software in a medical device, mobile medical applications, interoperability, wireless medical devices, patient-generated data, and in-silico validation/modeling.