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4 NEWS
14 JULY 2023 ausdoc . com . au
Is another $ 1.80 the fix for GP rebates ?
Antony Scholefield THE Medicare rebate for a standard consultation has risen from $ 39.75 to $ 41.20 this month , while GP groups expect a second increase to $ 41.55 later this year .
A 3.6 % indexation boost from July is significantly higher than the 30-year average ( 1.1 % annually ) yet still below the CPI , which was 7 % in the 12 months to March .
But the Federal Government says it will invest another $ 1.5 billion over four years into Medicare by rolling out a new indexation formula that will “ better align with changes in economic conditions ”.
A parliamentary budget analysis in May explained that the first indexation rise of 3.6 % was determined “ in line with the previous methodology ” but that another round of indexation was expected in November using the new formula .
However , before patients book that holiday , the AMA and RACGP have said they anticipate an increase of just 0.9 %.
The new formula will not be Medicare specific : the government says
Professor Steve Robson .
programs like aged care home support will also benefit . Buried on page 200 of one of the health budget statements , the government says the current formula , which has been around since 1996 , will be tweaked to factor in the Wage Price Index , with the intention of reflecting the cost of labour more accurately .
If you are wondering why the new indexation rate will most likely continue to trail inflation , the budget papers have an answer .
They state that the indexation rates “ include an incentive for programs to improve their efficiency over time ”, and this “ productivity offset ” is here to stay .
That said , AMA president Professor Steve Robson has welcomed the new indexation formula as a long-awaited acknowledgment of “ the successive underfunding in stealth of Medicare by substandard indexation ”.
Other Medicare changes from 1 July include the launch of new items for GPs to co-ordinate or take part in case conferencing for patients with eating disorders or a referral under the Better Access scheme .
First opioid deprescribing guidelines
FROM PAGE 1 patients with COPD or sleep apnoea , and those taking sedating medications , should also start the process of deprescribing if they were not experiencing benefits .
However , the authors said deprescribing should be avoided for patients with severe opioid use disorder , suggesting treatments such as buprenorphine or methadone , in combination with behavioural therapies .
Patients nearing end of life should generally continue opioid treatment , they added .
The guidelines , funded by the University of Sydney and the NHMRC , have been broadly welcomed .
However , Dr Sue Ieraci , an emergency physician , said they should not be misapplied to people for whom “ chronic pain leads to misery , poor function and loss of independence , and in whom there may be no suitable alternatives ”.
“ I have assisted older people in crisis who have been told that they can only take paracetamol for serious musculoskeletal pains [ given ] frequent NSAIDs are generally risky in this age group .
“ Leaving our elderly to suffer in silence will not keep them active and optimistic into older age .
“ Let ’ s not make the frail elderly live in pain to assuage our concerns about opiates .”
Pain specialist Associate Professor Michael Vagg said the guidelines supported the “ common sense ” approach of most GPs .
He said : “ If you acutely precipitate a severe withdrawal by just stopping [ opioids ] dead , then it may actually take a higher dose to get that patient stable again , once they ’ ve restarted .
“ It ’ s a losing situation all round : the patient ends up on a higher dose and they ’ re doubly afraid of coming off them .”
He added the suicide risk was “ very high ” in the first three or four months following opioid cessation . Med J Aust 2023 ; 25 Jun .
Associate Professor Michael Vagg .
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References : 1 . Cipriani C , et al . International J Nucl Med . 2017 ; July : 114 – 112 . 2 . Cipriani C , et al . J Dermatol Treat . 2020 ; DOI : 10.1080 / 09546634.2020.1793890 . 3 . Castellucci P , et al . Eur J Nucl Med Mol Imaging . 2021 ; 48 ( 5 ): 1511 – 1521 . 4 . Cipriani C , et al . In Therapeutic Nuclear Medicine . 2014 . RP Baum ( Ed ), New York : Springer . 5 . Australian Therapeutic Goods Administration . ARTG Public summary 400142 .
Please review the Product and User information before use . This can be accessed at www . oncobeta . com . Indication : Rhenium-188 paste for the treatment of skin cancer lesions and skin tumours . Currently not MBS funded . OncoBeta ® GmbH , Schleißheimer Str . 91 , 85748 Garching near Munich , GERMANY . SHOW4045 . B . Date of preparation : May 2023