The independent Electrocardiogram Review Committee has completed its final report. The report outlines the committee’s recommendations after considering high-level claiming data, qualitative feedback and submissions.
Key points
Out-of-hospital ECG MBS claims had reduced in the 12 months after the 1 August 2020 ECG changes, compared to the 12 months before.
The committee concluded this reduction may translate to poorer health outcomes in the long term. With health outcomes data not available for the 12 months after 1 August 2020, the committee considered patient access using MBS claiming data and qualitative evidence.
The committee noted that:
- ECG services had reduced, and out-of-pocket costs had increased, since the changes to the MBS ECG items
- the changes may have contributed to the service reduction, as costs represent a barrier to patient care
- the impact of the COVID-19 pandemic and advent of telehealth services (from March 2020) were important confounding factors.
The committee concluded that it was not possible to conclusively attribute the cause of reduced ECG services to just one variable.
Key recommendations
The committee made several key recommendations:
- Access for all medical practitioners (thereby allowing access for GPs) to the trace and clinical note item (11714) with an increase to the daily number of services claimable.
- Introducing a new item or amending existing ECG trace and report item 11704 for specialist/consultant physicians to access a trace and report item, which can be claimed with a consultation item.
- A fee structure based on the application of a clinical value tier structure.
Australian Government response
The Government considered the committee’s recommendations and:
- acknowledged the concerns raised by the committee and the overall reduction of ECG MBS claims (out of hospital) following the 1 August 2020 changes
- noted the other variables identified in the report, particularly the impact of the COVID-19 pandemic on face-to-face consultations and the advent of telehealth.
As the committee observed, without separating these variables it is not possible to attribute this decline to the MBS changes alone.
The Government has therefore instructed us to carry out another review of the plain ECG items once another 12 months of data becomes available. This will:
- allow claiming patterns to settle from the impacts of COVID-19
- provide a clearer separation from the 1 August 2020 changes
- provide greater opportunity to review health outcomes data, which was not available to inform the first review.
The newly established MBS Reviews Advisory Committee (MRAC) will carry out the next review. MRAC is an independent committee that aims to ensure the MBS continues to support high-quality care through a process of expert reviews.
