The MBS primary care items support a range of primary care services. 81 These items now allow GPs to refer patients with complex, chronic illnesses to other disciplines for up to five subsidised services per patient per annum and provide financial incentives for general practitioners to coordinate the care of a patient with a chronic condition with at least two other care-givers.82
The MBS items have been consistently raised as barriers to the success of multi-disciplinary care in the GP Super Clinics. In particular, it was perceived that there was inequity in access to MBS items between GPs and allied health staff. Claims for more equity in provision of financial incentives for allied health and nursing staff were raised consistently, particularly in relation to case conferencing.
Policy changes to MBS items are difficult in the context of limited evidence on patient outcomes and on the provision of effective multi-disciplinary care.42 The GP Super Clinics Program cannot address this problem. Rather, it is a broader health and primary care system problem which needs to be viewed in the context of evidence for achieving patient and population health outcomes, and effective multi-disciplinary care.
42Pearce C, Phillips C, Hall S, et al. Following the funding trail: Financing, nurses and teamwork in Australian general practice. BMC Health Services Research.11(1):38.
81MBS Primary Care Items: Department of Health and Ageing 2011.
82Harris MF, Jayasinghe UW, Chan BC, et al. Patient and practice characteristics predict the frequency of general practice multidisciplinary referrals of patients with chronic diseases: A multilevel study. Health Policy. 2011;101(2):140-145.