10.     Conclusions and implications of changes to the urgent after-hours items

The key conclusions of the Taskforce are:

  1. MBS funding should continue to be available for home visits, including in the after-hours period. Funding should continue to be available for after-hours services provided by a patient’s GP, as well as by a MDS.
  2. The rebates for ‘urgent’ after-hours services should only be payable in circumstances where a GP who normally works during the day is recalled to work for management of a patient who needs, in the opinion of the GP, urgent assessment. The higher rebate recognises the additional clinical value provided by, and lifestyle and financial imposts on, GPs who deliver these services to their own patients, the practice’s patients or patients of other local practices where on-call work is shared. In this setting it is more likely that there will be better patient triage, based on the GP’s (or a closely supervised GP trainee’s) knowledge of the patient’s circumstances, better access to patient records facilitating management, and better follow-up to ensure continuity of care.
  3. Where a business has been established specifically to routinely provide care in the after-hours period (including a MDS) then all of the other (non-urgent) items for after-hours services should remain available to these entities.
  4. The MBS items for urgent after-hours attendances should not be available where the patient has made an appointment prior to the commencement of the after-hours period (that is, 6pm on weeknights).

Rebates for after-hours Medicare services will continue to be available to all patients, with a higher rebate than GP services provided during business hours. The option of providing home visits and for practitioners to bulk-bill patients for these services will continue.

The urgent after-hours items will remain available where the GP who normally works during the day is recalled to work to manage a patient whose condition requires an urgent assessment that cannot wait until the next working day.