By Helen Carter
Optometry Australia is asking its members to tell it about the impact the Medicare fee cut and on-going freeze are having on their practices.
Members who are owners, partners or managers of a practice, including franchises, are being asked to complete a five-minute online survey. Responses will be important in helping provide sound evidence-based direction when lobbying the Australian Government for fairer patient rebates for optometry services.
National policy manager Skye Cappuccio says the survey is important to help ensure Optometry Australia has a clear picture of what is happening in practices and exactly how the Medicare rebate cuts and the extended freeze on indexation are affecting optometrists.
‘To ensure our policy and advocacy are most effectively targeted, we need a sound understanding of the impact on practice revenue of the Medicare fee cut and ongoing Medicare rebate freeze,’ she said.
‘We also need to understand what changes practices have made to help accommodate reduced revenue from Medicare services.
‘We know that private billing of Medicare consultations is not increasing. It’s not clear if practices are simply wearing the loss of reduced incomes from clinical services, or have been able to alter the way they do things to help reduce the impact of Medicare cuts.
‘The Health Minister Greg Hunt has made it clear that he doesn’t see a problem for patients in the rebate cut, because the bulk-billing rate has remained high. We need to ensure we understand the full story of the reasons that practices are continuing to bulk-bill the majority of patients, and the toll this is taking, so that we can be sure our advocacy messages cut through, ‘ Ms Cappuccio said.
Income cut nearly $10,000
Modelling by Optometry Australia estimates that practice incomes associated with Medicare rebates were $9,282 less per full-time optometrist in 2016 than they would have otherwise been, due to cuts in the Optometric Medicare Benefits Schedule rebate and the freeze on indexation.
If the Consumer Price Index had been applied to the Optometric MBS since 1997, patients would be receiving more than 30 per cent more today in rebates for optometric consultations. For example, for item 10910, Optometry Australia estimates the current rebate is $14 less than it would have been if fair indexation had been applied in line with CPI each year since 1998.
In an email message to members today, 17 July, Optometry Australia president Andrew Hogan urged them to support Optometry Australia’s advocacy on behalf of the profession by completing the survey.
‘We need five minutes of your time,’ Mr Hogan said. ‘Our campaign for the reintroduction of annual indexation for Medicare rebates for optometry has been ongoing and now we are beginning a final push for indexation to be reinstated a year earlier than the intended 1 July 2019. We are asking you to join us in educating our political representatives about the importance of optometry, and of supporting all middle-aged Australians to access a comprehensive consultation.
‘Health Minister Greg Hunt made it clear that the data indicate there isn’t a problem with the rebate. He pointed to the fact that bulk-billing rates are not decreasing and the numbers of patients accessing optometry services under Medicare continue to increase, suggesting there has been no real impact on patient access to eye care.
‘With an annual reduction in government investment in optometry services of more than $50 million, we know there is more to the story. We need your help to understand this, so we can tailor our advocacy for fairer rebates most effectively.’
Write to your MP
Optometry Australia is also calling on all members to write to their local MPs to request to meet with them, and to highlight the need to support more frequent access for middle-aged Australians to a comprehensive eye examination, by providing a rebate every second year for a comprehensive consultation for those aged from 40 to 64 years. Mr Hogan said rates of access to optometry services for 40- to 64-year-olds had declined since 2015.
He asked members to call for fairer rebates and rebates that support best practice care.
Optometry Australia urges members to adapt the letter template to help their federal representative understand why all middle-aged Australians need biennial eye examinations. The letter asks optometrists to advise that they are concerned that their patients in the 40 to 64 year age bracket are not getting their eyes tested in a timely fashion as per best practice and advise they have noticed a drop in patients in this age bracket accessing a comprehensive eye examination.
‘To deny asymptomatic patients a Medicare rebate for regular two-yearly eye exams puts them at risk of preventable vision loss,’ the letter states.
The Medicare rebate freeze has been in force since it was imposed temporarily by Labor in 2013. It has been repeatedly extended under Coalition governments, although GP services were indexed by two per cent on 1 July 2014.
The 2016-2017 Federal Budget announced an extension of the freeze, for a further two years, until 30 June 2020.
Then the 2017-2018 Federal Budget announced that indexation of Medicare rebates for optometry services would be reinstated from 1 July 2019. Optometry Australia continues to press for an earlier return to full indexation.
Optometry rebates were last indexed in 2012 and optometry was further affected by the freeze across the MBS in 2014, coupled by an across the board cut to the MBS rebate for all optometry services in 2015.
Due primarily to the indexation freeze and the five per cent cut on the MBS rebate for optometry services that came into effect from 1 January 2015, Optometry Australia estimates that government investment in primary eye care through Medicare has decreased by more than $103 million since 2015.
In 2015 the frequency with which ‘asymptomatic’ patients could access a rebate for a comprehensive eye examination changed, from every second year to yearly for those 65 years and older, and every three years for those younger than 65 years.
Timeline of events
November 2012: Medicare rebates for optometry last indexed before the freeze.
May 2013: Gillard Government suspends Medicare rebate indexation until 1 July 2014 to align indexation with 2014-2015 financial year.
May 2014: Abbott Government announces freeze on indexation for MBS and DVA rebates for optometry services until 1 July 2016.
December 2014: Abbott Government announces an extension of the freeze on MBS rebates for optometry by another two years until 1 July 2018.
January 2015: Five per cent cut to MBS rebates for optometry services commenced. Fee cap lifted and optometrists allowed to determine their own fees. Frequency with which ‘asymptomatic’ patients can access a rebate for a comprehensive eye examination changed, from every second year to yearly for those 65 years and older, and every three years for those younger than 65 years.
May 2016: Turnbull Government extends the rebate indexation freeze to 1 July 2020.
May 2017: Federal Budget announces that indexation of Medicare rebates for optometry services will be reinstated from 1 July 2019. The return to indexation of Medicare services will be phased in, beginning on 1 July 2017 with GP bulk-billing incentives. July 2018 will see the reinstatement of indexation of standard GP consultations and specialist attendances. Indexation of Medicare rebates for allied health follows in July 2019. Optometry Australia continues to press for an earlier return to full indexation.
TAKE THE OPTOMETRY AUSTRALIA SURVEY
Members, check your email inbox today for the message from Andrew Hogan which has a link to the ‘Impact of Medicare changes July 2017’ survey.