Uptake of Medicare Benefits Schedule items by psychologists and other mental health practitioners

Abstract

This paper provides a background to the mental health policy changes introduced by the Council of Australian Governments (COAG) in 2006. It then considers a major Australian Government COAG reform, the revision of the Medicare Benefits Schedule (MBS), by analysing the month-by-month utilisation of the available time-series data for the 17-month period (1 November 2006-31 March 2008) when new items for psychologists, social workers and occupational therapists were introduced. There are a number of unique problems associated with monthly time-series data. Essentially, there is a problem of heterogeneity that arises from the non-uniformity of the temporal unit of a 'month'. Second, there is an issue of the population covered by Medicare altering through time. Both of these problems are addressed in the present analysis of the time-series data. The two groups of psychologists created by the MBS changes dominate the provision of the new services, providing 96.4% of the new services. Psychologists, who are not deemed clinical psychologists in the MBS changes, are the group providing most of the services. Virtually all services are individual, not group, and are provided in a consulting room. The temporal adoption of the new items was continuing to grow by March 2008. Implications of this analysis for psychologists are discussed.

Women's uptake of Medicare Benefits Schedule mental health items for general practitioners, psychologists and other allied mental health professionals

“…It is therefore critical that the impact and equity of impact of these items are assessed further. This imperative exists not only because of costs to government, which have been described as considerable 7 , 19 but also in view of the added economic stress on individual women and the potential for the scheme to increase health inequalities. If women who have difficulty managing on their available income and who have lower educational levels are less able to make use of mental health services despite their mental health needs, the scheme does not necessarily address gaps in service provision as intended.…”

“…According to Medicare data, uptake of MBS mental health items has been rapid and substantial. From November 2006 to October 2007, the items accounted for 1 209 191 services 7 . Growth was greater in metropolitan locations compared with rural and remote areas, 6 and it was thought that initial beneficiaries were largely those already receiving counselling services 5 .…”

Planning estimates for the provision of core mental health services in Queensland 2007 to 2017

“…Initiatives included as part of the Council of Australian Governments (COAG) Action Plan for Mental Health (Council of Australian Governments, 2006), notably the introduction of the Better Access to Psychiatrists, Psychologists and GPs through the Medicare Benefits Schedule initiative, have resulted in substantially increased levels of primary mental health care activity (Whiteford et al, 2008) which could not have been predicted, but need to be monitored over time. Queensland data regarding primary care activity were not readily available at the time, however even if they were they may not necessarily have provided an accurate basis for prediction of future activity.…”

Mental health service use: Is there a difference between rural and non-rural women in service uptake?

“…Government mental health initiatives such as the Better Access Scheme (BAS) have contributed to addressing the increasing rates of mental illness in Australia by improving the availability of services. [30][31][32][33] Previous evaluations of the BAS have examined its ability to correctly service unmet needs. [30][31][32][33] Previous evaluations of the BAS have examined its ability to correctly service unmet needs.…”