Compromise Figure of a Single tier that will not change Government expenditure:
– Total expenditure on 50+min sessions in 2018 from 1st January to 31st October is $436,953,460.60.
– The total number of sessions for that time is 4,241,448.
– If we divide the total cost for tier 1 & 2 by the number of sessions completed by tier 1 & 2 we come up with a Medicare Rebate of $103.02 per 50+ min session.
– Basically what this means is that a single rebate for psychologists if set at $103.02 per 50+min session would end up the same costing as the two tiers.
– It would mean a $21.48 drop in the top tier rebate and a $18.22 rise in the lower tier rebate.
Comparing expenditure difference from 1st January 2018 to 31st October 2018 between Tier 1 and Tier 2 (50+min Psychological Services) Under the MBS
– Tier One provided 45.9% of treatment at 55.5% of the total cost
– Tier Two provided 54.1% of treatment at 44.5% of the total cost
– Tier One cost $47,741,473.40 more for 348,316.00 less appointments between 1st January to 31st October 2018
– This equates to Tier One costing $157,044.32 per day more for 1,145 per day less treatment sessions
Figures taken from the Government Link below:
It is important to note that:
1) Pirkis et al 2011 showed that tier two actually had slightly more severe cases referred to them than tier one as measured by the K10 and DASS.
2) The APS has conducted surveys of members on type and severity of conditions treated under Medicare. It suggests something like 85% (can’t remember exact figure) of psychologists under Medicare have referred comorbid high intense/severe cases
3) The definition of practice scope that is outlined by the Government in relation to the conditions that can be treated under Tier One and Tier Two is EXACTLY the same. What this means is that the Government has commissioned both tiers to treat the exact same conditions.
4) Below is a list of conditions that both tiers have been commissioned to treat under the MBS.
Mental disorder’ is a term used to describe a range of clinically diagnosable disorders that significantly impact on a person’s emotions, thoughts, social skills and decision-making. The Better Access initiative covers people with mental disorders arising from:
• Alcohol use disorder
• Anxiety disorders
• Adjustment disorder
• Attention deficit disorder
• Bereavement disorder
• Bipolar disorder
• Conduct disorder
• Co-occurring anxiety and depression
• Drug use disorder
• Eating disorders
• Obsessive compulsive disorder
• Panic disorder
• Phobic disorder
• Posttraumatic stress disorder
• Psychotic disorders
• Sexual disorders
• Sleep problems