Medicare Benefits Schedule (MBS) Review Advisory Committee: Post implementation review of changes to colonoscopy MBS items

Overview

The Medicare Benefits Schedule (MBS) is a list of health professional services (items) that the Australian Government subsidises. MBS items provide patient benefits for a wide range of health services including consultations, diagnostic tests, therapy, and operations.

When changes are made to MBS items, a review is undertaken approximately 24 months after to analyse and examine the performance of the changes. This is called a post implementation review. Post implementation reviews also provide an opportunity to confirm that the item changes are achieving their intended outcomes.

On 1 November 2019, a number of changes to colonoscopy and related items came into effect, resulting in eight new MBS items and the removal of four existing items. Read more about the changes made to colonoscopy items in November 2019. 

These changes were in response to the work done by the Gastroenterology Clinical Committee as part of the MBS Review Taskforce in reviewing colonoscopy services funded through the MBS.

Through their work, the committee identified concerns regarding the different patterns of servicing across the country and between practitioners, with variation in most services correlating with patient location and socioeconomic status (SES)

The committee noted that access to colonoscopy services may be compromised by a high volume of low value services (asymptomatic low risk patients undergoing too frequent screening), which may be contributing to decreased access for those in rural and remote and low SES areas.

In response, the Taskforce recommended that MBS items for surveillance colonoscopy services be restructured to align more closely with the Cancer Council Australia/National Health and Medical Research Council Clinical practice guidelines for surveillance colonoscopy.

In August 2022, through its role under the MBS Continuous Review, the MBS Review Advisory Committee (MRAC) agreed to establish the Colonoscopy Working Group to perform a post implementation review of the 1 November 2019 changes to MBS funded colonoscopy items.

In undertaking this work, the Colonoscopy Working Group developed a draft findings report with a number of recommendations that aim to strengthen the aims of the 2019 changes, further promote equity of health access and reinforce best current practice across the relevant MBS items.

Read more about the MBS Continuous Review and the MBS Review Advisory Committee. 

You can find links to download the draft findings report developed by the Colonoscopy Working Group at the end of this page. 

Why your views matter

In undertaking this post implementation review, the Colonoscopy Working Group developed the below draft findings report, which also includes a number of draft recommendations to strengthen and reinforce the MBS and its stated principles.

The MRAC seeks views from clinicians, peak bodies, consumers and other interested parties on this draft findings report. Your feedback on this report and its recommendations will assist the MRAC in producing a final report, and make recommendations to the Minister for Health and Aged Care and the Australian Government.

Your feedback will ensure the MRAC is aware of stakeholder concerns, perspectives and experiences as well as any concerns or consequences of the draft recommendations found within the report. All responses received will be considered in the finalisation of the post implementation review of colonoscopy services and the development of a final report.  

What happens next

Once the consultation period concludes, the committee will consider all feedback received and produce a final report. Feedback will be summarised in the final report and individual submissions will not be identifiable.

Once a final report has been produced, it will be provided to the Minister for Health and Aged Care for consideration, and published online on the department's website.

Read more about the MBS Continuous Review, the MBS Review Advisory Committee and other current and completed reviews.