Health funds back evidence-based approach to improving the MBS by reducing low-value

30 Apr 2018Media Releases

Private Healthcare Australia CEO, Dr Rachel David, said the Government’s response to the latest MBS Review Taskforce recommendations was an endorsement of evidence-based healthcare in Australia and would lead to better health outcomes and value for consumers.

“The PHI industry has long supported this clinician-led review which makes recommendations to the Government on how the MBS can be modernised to improve patient outcomes, safety and reduce waste,” said Dr David.

“Health funds want to ensure their members are getting value for money and to reassure them their premiums are not being spent on low value treatment.

“The more low-value tests and treatments are eliminated, the easier it will be to keep downward pressure on premiums, and invest members’ funds in procedures which really work.

“Under legislation health funds are obliged to pay for medical treatments covered by the MBS. This Review will not only highlight the importance of clinical best practice and improve patient care, but importantly reduce waste across the health system.

“Health funds will work with Government to ensure there is compliance with the MBS schedule. It is an excellent focus on evidence-based healthcare and will be supported across the health sector,” she said.

Dr David said the latest recommendations which included changes to the MBS items for spinal surgery to reflect contemporary surgical practice would ensure patients will receive rebates for spinal surgery services that are clinically appropriate and reflect modern clinical practice.

Other accepted recommendations include:

  • Limiting the ability of GPs to request knee MRIs for patients over 50 years and to align the number of services that can be requested by GPs with specialists. Specialists will still be able to request knee MRIs for all patients. These changes will reduce unnecessary MRIs and help ensure patients are receiving the right test, at the right place, at the right time;
  • Amendments to ensure patients aren’t undergoing painful procedures to have skin lesions removed when it isn’t clinically necessary.

Dr David said the recommendations accepted by the Government which included 38 in full and two in part, would continue modernise the MBS system and deliver an improved health system for all Australians.


Media contact: Jen Eddy  0439 240 755