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1. What it means for patients.

2. How it impacts on community focused radiology clinics and their ability to provide bulk-billed service to the community.

Timeline

The changes to diagnostic imaging including MRI services will be effective from 1 July 2016, while the Better Access to Radiation Oncology Programme will cease in 2016-2017.

MRI

Bulk billing incentives for MRI services will be reduced from 15 to 10 per cent of the Medicare Benefits Schedule fee.

Position statement by RANZCR “The proposed changes today are a poor outcome for patients. Diagnostic imaging and MRI are essential medical services, and particularly so for cancer patients.”

Overall Impact on Patient Diagnostic Pathway

Health advocates, like the AMA are worried about the impact. Consumers Health Forum chief executive Leanne Wells said many patients requiring pathology tests would now face out-of-pocket costs for the first time under the new budget measures, if pathology practices fail to absorb the impact of reduced Medicare benefit payments.

A threat to early detection, diagnosis and care

This could happen when the government ends an incentive for bulk billing in July next year. An X-ray will cost the patient up to $56 out of pocket, an ultrasound could cost up to $101, and an MRI $173 when the government slashes Medicare rebates for diagnostic imaging in July, according to the Australian Diagnostic Imaging Association. “Access for patients is of primary concern. These cuts will reduce the number of imaging providers who are able to offer bulk billing and increase the healthcare cost for patients who will have to pay the full amount for their services out of pocket up front and await reimbursement,” according to incoming RANZCR President, Dr Gregory Slater. The Federal Government’s proposed $650 million cut over four years to Medicare means that in diagnostic imaging, bulk billing incentives will no longer apply to non-concession card holders over the age of sixteen.

Lack of industry consultation

 “RANZCR has committed to the Medicare review and other government reform processes in good faith, but the lack of consultation with medical and health organisations about the extent and nature of these cuts is a breach of trust.” “These proposed cuts have not been exercised in the spirit of collaboration, nor are they evidence based. The data to support these changes have not been made available to us. RANZCR is keen for a review with consultation,” Dr Gregory Slater said. Out of pocket cost means patient cancel scans On average between 5 and 6 out of 10 patients either cancel a planned MRI scan or postpone significantly once they find out there is an out-of-pocket fee.

End of community care?

Community based radiology groups like Marina Radiology built their business and reputation on the ability to provide sustainable, quality service at a affordable cost to the community. Proposed Medicare cuts mean that this model will be unsustainable and it will be the patients that suffer most.