More Medicare support needed for chronic wounds

Australian Medical Association/AusMed

The AMA has provided a submission to the Medicare Benefits Scheme (MBS) Review Wound Management Working Group, and has called for better support for people suffering from hard-to-heal wounds.

The Wound Management Group has been tasked with reviewing 13 MBS acute wound management items and related recommendations of other MBS committees and to look at mechanisms other than the MBS to support chronic wound management.

The AMA’s submission primarily focusses on overcoming the barriers to providing optimal chronic wound management, the majority of which is provided in general practice.

It wants to see patients supported to access best practice wound management and that medical practitioners are supported to provide best practice care.

An estimated 400,000 Australians have chronic wounds, including venous leg and diabetic foot ulcers.

Management of these can take months and in some cases years.

AMA President Dr Tony Bartone said many of those patients are older Australians and with limited incomes.

“Wherever possible, their GP will bulk bill patients for their care,” Dr Bartone said.

“But GPs and practices are increasingly unable to absorb the cost of providing the bandages and dressings that their patients need each visit, which can cost between $4 and $50 per patient.

“Under Medicare restrictions, GPs cannot bulk bill a patient for a consultation and charge the patient just the cost of the bandage.

“This means that they have to decide between bulk billing the patient and absorbing the cost of the bandage themselves, or charging the patient for both the consultation and the dressing.

“General practices, after years of frozen and inadequate rebates for the cost of care, are just not in a position to subsidise this cost.”

In many cases, patients buy their bandages or dressings at market rates from a pharmacy, just so the GP treating the wound can bulk bill them for the consultation without falling foul of legislative restrictions.

Dr Bartone stressed that chronic wounds are debilitating for patients, causing a myriad of complications including constant pain, social isolation, and depression or anxiety, and the cost of bandages and dressings is prohibitive for many people.

“As such, there is an imperative for the Government to support best practice care,” he said.

In its submission, the AMA has suggested two possible solutions to the current dilemma.

On is to provide general practices with a stock of Government-funded dressings.

The other suggestion is to develop a wound consumables schedule that GPs could bill against to cover the costs of dressings and bandages provided to patients.

The AMA encourages the working group to ensure that any recommendations they make support GP stewardship and the patient centred medical home, and do not undermine the collaborative care arrangements already in existence, or wilfully fragment care.

It is vital there is qualified clinical oversight of patient care, so as to guard against delays in appropriate treatment, unnecessary testing, and inappropriate referrals.

The AMA will make a further submission to the Working Group when it has completed reviewing the draft recommendations made by other MBS Review groups around acute wound items.

/AMA/AusMed News. View in full here.