Overview of the 2023-2024 budget and its implications for allied health

The 2023-24 Federal Budget contained little of direct relevance to the osteopathy profession, however, there were several measures announced that may have some impact on osteopaths.

There is a lack of detail about many of the budget initiatives, but the new measures are aimed at improving patient access to affordable multidisciplinary care, and the increased investment in the health system is a good sign. While clearly, the focus of these health investments has been on GPs, it is hoped that with continued advocacy efforts by Osteopathy Australia, some of the reforms to be implemented will have benefits for osteopaths.  

Here is a summary of some of the key initiatives that were announced:

$98.2 million for new Medicare rebates – including larger rebates for longer consultations:

• Patients who require consultations of longer than 60 minutes will receive a larger Medicare rebate - this is intended to support doctors to provide high quality care to people with chronic or complex needs, and there may be some flow-on benefit for osteopaths involved in the care of patients with chronic care needs.

• It is hoped that this measure may lead to better coordinated multidisciplinary team-based care, but more details are needed on this and the proposed changes to the Chronic Disease Management (CDM) Program (see below).

CDM Item changes:

• From 1 November 2024, the GP CDM planning and review items will be restructured, and the current GP Management Plan (GPMP) and Team Care Arrangement (TCA) will be consolidated into a new CDM planning item.
• Transition arrangements will be in place from 1 November 2024 to 31 October 2026 to allow patients to transition to the new CDM plans -patients will be able to continue to access allied health services using their existing GPMPs and TCAs during the transition period.
• Based on the limited information available, we do not at this stage see this restructure as having a negative impact on osteopaths.

Support to PHNs for commissioning multidisciplinary healthcare teams

• $79.4 million over four years for PHNs to support multidisciplinary teams to improve the management of chronic conditions and reduce avoidable hospitalisations.

• Smaller general practices will be able to complement their teams with the services of allied health professionals that have been commissioned by PHNs.

• PHNs will have a much stronger role in commissioning additional allied health services – so it is important for Osteopathy Australia to continue to engage with the PHNs to advocate for the inclusion of osteopaths in these teams.

Increased funding for Workforce Incentive Program – Practice Stream (WIP-PS)

• More than $400 million over four years to improve the quality and accessibility of multidisciplinary primary care and improve financial sustainability of multidisciplinary general practice by immediately increasing all payments under the WIP-PS.
• The increased funding is welcome, but Osteopathy Australia and many of our allied health colleagues have concerns about whether the WIP is an effective mechanism to improve access to multidisciplinary care, so we are keen to see this program evaluated and will be pushing for greater accountability in how the funding is used.

Scope of practice review

• $3 million in 2023-24 and 2024-25 to review current models of care against community needs and recommend appropriate expansion to scopes of practices and models of care for a range of health professionals providing primary care services (both registered and self-regulated, including medical practitioners, nurses, midwives, and allied health).
• More details about the review process are required, but potentially this review may provide an opportunity to explore the option for osteopaths to directly refer to specialists, to expand diagnostic imaging referral rights for osteopaths, and to address some of the current barriers to osteopaths working to full scope of practice in different areas (e.g. aged care, disability, occupational health).

Digital Health and My Health Record (MHR)

• $951.2 million for digital health - The Australian Digital Health Agency will upgrade and modernise MHR, making it easier for patients and providers to use and support the secure, safe and efficient sharing of information.

• $6.1 million to increase allied health professionals’ connection to MHR.
• Hopefully if allied health professions, including osteopaths, are supported to have full access to MHR (with the ability to upload to the patient record), this will improve health outcomes for patients and reduce duplication in the system.

Aged care:

• Sadly, there was no dedicated funding for allied health announced.
• However, there were significant funding commitments made to aged care more broadly, some of which present opportunities for allied health engagement to improve residential aged care:
  • $139.9 million over four years to improve the accountability and transparency of approved aged care providers through enhancements to the Star Rating system.
  • $72.3 million in 2023–24 to support the development and implementation of a new, stronger Aged Care Regulatory Framework to support the new Age Care Act which is due to commence from 1 July 2024.  
  • $25.3 million in 2023–24 to ensure the Aged Care Quality and Safety Commission (ACQSC) is appropriately resourced to deliver its audit and compliance program.  
• Implementation of Support at Home Program for In-Home aged care has been further postponed until 1 July 2025 – this is a good thing, as it will hopefully allow allied health professions more time to work with Government counterparts to implement a better quality program that ensures better access to allied health services.
• A new Aged Care Taskforce will be established to inform the design of the Support at Home program and to review aged care funding arrangements more broadly, with the aim of developing options to make the system fair and equitable for all Australians – it is hoped that allied health professions will somehow be able to engage with this taskforce to ensure allied health needs of older Australians are adequately addressed.

NDIS:

• Significant changes to the NDIS are anticipated as the Government aims to ensure sustainability of the scheme, and it is hoped that allied health professions will be adequately consulted about the changes and involved in co-design of key initiatives, particularly with regard to:
  • Blended payment models 
  • Service innovation 
  • Effective outcome measurement 
  • Increased use of evidence-based supports  
  • Access to quality, safe services throughout the country 

First Nations health:

• $818.5 million for: early intervention and education programs to reduce smoking and vaping rates and to increase the uptake of regular health checks; preventive health measures to minimise the impacts of COVID-19 on First Nations people living in remote communities; measures to improve access to aged care, renal and cancer care services for First Nations peoples.

• MBS items – from 1 March 2024, there will be streamlined access to the 10 allied health services for First Nations Australians with a chronic condition, or following a Health Assessment, through MBS items 10950–10970, 93000, 93013, and 81300–81360, 93048 and 93061 – all 10 items will be able to be accessed following either a GP Medical Plan/Team Care Arrangement or Health Assessment (rather than requiring both).

• $47.2 million will be provided over five years to trial integrating services and explore the use of joint commissioning across primary health, disability, aged care, and veterans’ care sectors in up to ten locations to improve access to services, including allied health, in rural and remote locations and First Nations communities.

• It is hoped that these measures if implemented appropriately will improve access to services by First Nations communities.