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Title page

Contents

Summary 4

Telehealth services in Australia 4

Clinician uptake 4

Patient uptake 5

Telehealth business models 5

Balancing access, quality and safety 6

Comparing telehealth to face-to-face health care 6

Video vs telephone 6

Telehealth in the MBS 7

MBS Telehealth Principles 7

Appropriate types of telehealth services 7

Asynchronous telehealth 7

Eligibility requirements and exemptions for telehealth services 8

Strengthening access to patient-end support 9

Recommendations 10

Recommendation 1 10

Recommendation 2 10

Recommendation 3 11

Recommendation 4 11

Recommendation 5 11

Recommendation 6 11

Recommendation 7 11

Recommendation 8 11

Recommendation 9 11

Recommendation 10 11

Acronyms, abbreviations and definitions 13

Introduction 14

Minister's request for this review 14

Balancing access, quality and safety 15

Research and systematic literature reviews 15

Limitations of the research 15

Telehealth as a substitute for in-person care 15

Comparing video and telephone consultations 16

Clinician use of telehealth services 17

Patient use of telehealth services for primary health care 20

Initial telehealth consultations for non-GP Specialists 21

Telehealth consultations for nurse practitioners and midwives 22

Online-only telehealth models 23

Populations and services where access can be optimised with telehealth 23

MBS Telehealth Principles review 26

Preamble 26

Principle 1 26

Principle 2 27

Principle 3 27

Principle 4 27

Principle 5 28

Principle 6 28

Principle 7 29

Principles 8, 9 and 10 29

Telehealth services review 31

Optimal telehealth care, and phone and video services 31

Reimbursing asynchronous care 32

Telehealth eligibility requirements and exemptions 33

Nicotine cessation temporary MBS items 34

Temporary MBS BBVSR items 34

Continuation of exemption for non-directive pregnancy counselling MBS items 35

Continuation of exemption for GP mental health MBS items 35

Continuity of care and consistency of eligibility requirements 36

Non-GP specialist attendances 37

Home visits and patient-end support services 38

Consultation and feedback review process 40

Telehealth Principles 40

Consultation on the draft report and recommendations 40

Consumer Health Forum workshops 41

Appendix A. MBS Continuous Review and committee 42

Medicare Benefits Schedule Continuous Review 42

Medicare Benefits Schedule Review Advisory Committee 42

MBS Continuous Review Guiding Principles 43

Government consideration 44

References 45

Tables

Table 1. Number of non-GP Specialist patients' use of services by rurality and modality 22

Table 2. Subsequent consultations 31

Figures

Figure 1. Department of Health and Aged Care analysis of MBS data - Cumulative uptake of MBS COVID-19 telehealth services (unique service providers) 17

Figure 2. Department of Health and Aged Care analysis of MBS data - Proportion of telehealth consultations by MBS broad type of service, April 2020-June 2023 17

Figure 3. Department of Health and Aged Care analysis of MBS data - MBS broad type of services, proportion of services by telehealth (phone and video),... 18

Figure 4. Department of Health and Aged Care analysis of MBS data - Percentage of video telehealth consultations, by clinician,1 July 2020-31 March 2023 19

Figure 5. Department of Health and Aged Care analysis of MBS data - Proportion of services by telehealth, by broad type of service and rurality (MM 1-7),... 19

Figure 6. Department of Health and Aged Care analysis of MBS data - Patient use of telephone and video services, January 2020-June 2023 20

Figure 7. Department of Health and Aged Care analysis of MBS data - Overall patient use of total non-GP specialist services by delivery type and rurality 22

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