The diagnostic imaging sector has accepted a cut to bulk-billing incentives in return for a review expected to increase the Medicare rebate and a promise the rebate will be unfrozen in future.
In December the Coalition government announced a plan to cut the bulk billing incentive for diagnostic imaging and scrap it for pathology services, saving $650m over four years.
The cuts to diagnostic imaging limit bulk-billing incentives to concessional patients and those under 16, consistent with current incentives paid for GP services.
On Sunday the health minister, Sussan Ley, announced the Australian Diagnostic Imaging Association (Adia) had accepted a deal with the government over the cuts.
The cuts to the bulk-billing incentive will be delayed by six months – until 1 January – to allow time for an “independent evaluation of the commercial pressures facing diagnostic imaging providers”, Ley said.
She said the government was prepared to invest as much as $50m more “to help improve patient access to affordable and safe scans and imaging procedures”, depending on the outcome of the evaluation.
The chief executive of Adia, Pattie Beerens, told Guardian Australia that diagnostic imaging providers had had to pass costs on to patients because the Medicare rebate for their services had been frozen for 18 years.
Beerens said the $50m investment foreshadowed by the government would allow increases in the rebate for certain services, decreasing the gap paid by patients, which averages $100 and can cost up to $150 for complex tests.
“The independent evaluation will show where the Medicare rebate should rise. One such area is diagnostic mammography, which is very difficult to access and pay for because the rebate is less than half of the cost [of the test]. In our view, that would be an obvious one [for a rebate rise], but there are shortfalls everywhere.”
Under the deal, Ley has also committed to ensure that diagnostic imaging indexation resumed when the GP rebate indexation freeze concluded in 2020.
Beerens said unfreezing the Medicare rebate would give the sector clarity and certainty about the government subsidy for their services after the election.
“We’re delighted by that announcement,” she said. “At the moment Medicare indexation does not include diagnostic imaging. We’re keen to ensure it does. It makes no sense ensuring people can afford to go to the GP if they can’t afford the scans they need [for a diagnosis].”
The agreement follows a peace deal with Pathology Australia under which it accepted the sector’s share of the $650m cuts in return for the government legislating to tackle the rents pathologists are charged to house their practices with other medical services.
That deal is likely to leave pathologists millions of dollars better off, with the biggest provider Sonic Healthcare estimated to be $50m to $70m ahead, according to an industry analyst.
At a doorstop on Monday Labor campaign spokeswoman Penny Wong said the government had “rolled over on pathology and diagnostics, the changes there which have apparently been the subject of an agreement with the sector”.
“There’s a cost to that – they haven’t told anybody how it’s funded or what it will cost.”
Labor’s health spokeswoman, Catherine King, said it was “another example of a government in chaos”
“Less than six months ago, the government cut more than $300 from vital scans. Now, they say they’ve changed their minds.”
“There’s no detail on how this deal will affect patients, and no guarantee that bulk billing will be maintained. This deal is about saving Malcolm Turnbull’s job, not protecting patients and Medicare.”
The Coalition campaign spokesman Mathias Cormann said: “We have made an announcement here which would lead to a further review. There will be a small impact from that decision of about $50m and that will be reflected in our costings.”
Ley said: “The Coalition is committed to ensuring access to affordable diagnostic imaging for all Australians.”
Ley recognised technology and automation had not reduced the cost of most diagnostic imaging services, which needed specialist doctors to supervise the examination and analyse the results.
“This independent evaluation will ensure we can work together with the diagnostic imaging sector to pinpoint exactly where possible improvements can be made in the broader system and ensure this significant additional investment is targeted where it will have the most benefit for patients,” she said.
Beerens called on Labor to announce it would unfreeze the diagnostic imaging Medicare rebate, as it has done for GPs.
