More than 150 Medical Benefit Service (MBS) items that potentially offer little benefit compared to their cost - paid for by taxpayers – have been flagged for further investigation in research published in the 19 November issue of the Medical Journal of Australia.
Dr Adam Elshaug, who holds joint appointments at The University of Adelaide, Harvard Medical School in Boston, and The Commonwealth Fund in New York, developed a method of scanning various sources to identify MBS items that might be unsafe, ineffective or used inappropriately. The project is part of a larger effort by Australia’s Department of Health and Ageing to improve the quality and sustainability of Medicare into the future.
Dr Elshaug said being able to identify health care services that delivered minimal outcomes would allow governments, who as stewards of taxpayer funds are making tough decisions with health expenditure, to reallocate funding to more beneficial or cost-effective services. “Limited resources mean that nations cannot escape having to make difficult health care choices,” Dr Elshaug said.
“Identifying and reducing the use of low-value care, or ‘waste’, is becoming a priority for an increasing number of jurisdictions.”
“Each recognises that cost savings or cost-neutral changes can be made within existing health budgets by reducing the use of existing services that offer little or no benefit. This would allow funding to be reallocated to more beneficial or cost-effective services, thus maximizing health gain,” Dr Elshaug said.
In an accompanying article, Dr Ian Scott from the Princess Alexandra Hospital, Brisbane examined the difficulty of developing an evidence-based, transparent method for removing funding from low-value health services that is sensitive to the needs and concerns of both patients and clinicians. Dr Scott said identification of low-value services must involve Australian specialist colleges and concerted effort was needed to understand and reverse the continued use of these services.
“The aim is not to reduce current health expenditure or impose ad hoc rationing of services, but instead to reallocate limited resources to interventions of proven value,” Dr Scott said.