Welcome to the Podiatry Arena forums, for communication between foot health professionals about podiatry and related topics.
You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members (PM), upload content, view attachments, receive a weekly email update of new discussions, earn CPD points and access many other special features. Registered users do not get displayed the advertisments in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!
If you have any problems with the registration process or your account login, please contact contact us.
PHYSIOTHERAPISTS, podiatrists and occupational therapists are preparing to push for much greater Medicare funding, following a federal government decision to review how decisions are made on adding services to the taxpayer-funded scheme.
The three groups say Medicare is too doctor-focused, and they are planning submissions to the review that will point out how the Government can save thousands of dollars per patient by allowing the scheme to pay allied health professionals to treat patients instead.
In one example, the Australian Physiotherapy Association says the Medicare-funded treatment for stress urinary incontinence -- surgery -- can cost more than $4000 per patient. The same condition can be safely and effectively treated by a physiotherapist with non-invasive treatments costing $600 to $700.
Unlike the surgical option, the cost of the physiotherapy treatment is met by the patient, assisted by private health cover if they have it.
The review of health technology assessment, announced by Health Minister Nicola Roxon and Finance Minister Lindsay Tanner just before Christmas, creates another potential flashpoint for tension within the medical lobby, which has reacted cautiously to the prospect of any widening of access to Medicare.
The review will examine how to streamline and improve the processes for approving new health technology, services and drugs, to ensure "only medical services and devices which are clinically proven and provide value for money attract government funding".
Details on the submissions process for the review are expected shortly. It will deliver its report late this year.
Physiotherapy and other groups said yesterday they hoped the move would lead to greater openness of Medicare to non-medical, cost-effective treatments.
Peter Fazey, immediate past president of the Australian Physiotherapy Association, said: "The current process, which is run by the Medical Services Advisory Committee, is run by the medical professionals and isn't open to the services offered by non-doctors.
"We are very hopeful that the results of this review will be the inception of a similar sort of committee that will be in a position to assess interventions whoever might be providing them, for inclusion on the Medicare Benefits Schedule."
In recent years, some Medicare rebates have been created that refund part of the cost of seeing an allied health professional, such as a physiotherapist, though these come with strict conditions.
Australian Medical Association president Rosanna Capolingua warned there was a danger that a review partly driven by the Treasury would be focused more on cutting costs than on improving patient care.
"It creates another layer of cost -- patients may find they see a nurse practitioner, and then have to see the doctor anyway," she said.
__________________
***************************************** Remember, it's just a foot.
Re: Physios, podiatrists and occupational therapists seek more Medicare funding
New push for nurses to take doctors' roles
Adam Cresswell, Health editor | January 08, 2009
Article from: The Australian
Quote:
A RAPIDLY expanding chain of private clinics has applied for permission to run a pilot scheme under which prescriptions written by nurses would qualify for Pharmaceutical Benefits Scheme subsidies.
The Revive Clinic chain, staffed entirely by highly trained nurse practitioners, has also sought federal government permission for its consultations to be covered by Medicare -- a demand likely to infuriate the doctors lobby.
The groundbreaking plan, contained in a submission to the Preventative Health Taskforce, says "greater access and equity of access to nurse practitioner services in the community is required".
Patients of Revive -- which has opened its first nurse-run clinic in Perth and plans up to 20 more nationwide -- cannot claim their visits on Medicare and/or their prescriptions on the taxpayer-subsidised PBS.
Federal Health Minister Nicola Roxon has long championed the need both for better health prevention and more effective use of nurses.
In October, she declared to a nurses conference that she was a "firm believer in the vital role nurse practitioners can play in our overall health system".
Ms Roxon cited lack of access to PBS subsidies for nurse practitioners as a barrier, and told the conference that reform processes in train would "entail a redefined and extended role for nurses -- including nurse practitioners".
The first nurse-run Revive Clinic opened in Perth in November. Under West Australian law, its nurses are allowed to treat patients for a defined list of minor conditions, ranging from colds, coughs and flu to bronchitis, ear infections, skin infections and bladder infections as well as nausea, vomiting and diarrhoea.
They can also prescribe drugs for these conditions that are classified as S4 -- a category that includes various antibiotics but excludes strong painkillers such as morphine, and other powerful medications such as for cancer and heart problems.
But these state laws do not affect Medicare and PBS eligibility. As a result, patients attending the Perth clinic have to pay a consultation fee of $65 out of their own pocket.
Revive director and owner Louise Stewart said doctors were overstretched in many places, and towns where the chain intended to set up clinics included Port Hedland, where four general practitioners were struggling to meet the needs of 17,000 residents -- nearly three times more patients than recommended under professional guidelines.
The submission to the taskforce argued for nurses' consultations to be covered under Medicare for health prevention services, health checks and the development of care plans.
These are currently among the single most lucrative Medicare-funded services for doctors, being worth $175 to a GP for a health assessment of a patient over 75, or $130 for development of a management plan for patients with complex health needs.
Australian Medical Association president Rosanna Capolingua warned against the proposed trial, saying the existing ranks of nurses working under GP supervision within doctors' surgeries was a safer and more cost-effective model.
"They don't seem to get the fact that they don't have the training," Dr Capolingua said.
"If they are pretending to be doctors, I invite nurse practitioners to go to medical school and to do the training required."
__________________
***************************************** Remember, it's just a foot.
Re: Physios, podiatrists and occupational therapists seek more Medicare funding
How much does it cost to prevent a diabetic foot ulcer, correct fitting shoes, the right orthosis as to how much it cost to heal an ulcer in a diabetic or possible amputation ?
Would love to know how much on average it cost to heal an ulcer here in Australia?
Re: Physios, podiatrists and occupational therapists seek more Medicare funding
Dear All,
In the UK where i used to work it was approx $1300 per bed day for an admission onto the Diabetes Vascular Unit. Average stay was 6 weeks. The costs went up when Consultants and other hangers on attended to the pt.
so 1300 x 7 days is $9100 then
6 weeks is $54600 which is above the average salary in Aus.
So preventing one diabetic admission is more than the average salary.
To t/t in a community based at risk foot clininc is much cheaper than an admission but you still need to do weekly or 3 x weekly dressings for a period of a few or several weeks with Hopsital ouypatient appts in support. So again costs mount up quite quckly.
So specialised shoes at say $600 plus nice socks $50 and frequent relevant podiatric care combined with good medical management is the cheapest way to go.
But just try telling an Health Service Manager or even worse a POLITICIAN.
Physios, podiatrists and occupational therapists seek more Medicare funding
Hybrid Mode
