Sydney Australia, 13 September 2020. Medicare has rebated allied telehealth services, including much needed psychological services, since March 2020. This has enable them to be accessible during COVID and has been absolutely critical in enabling 7 million Australians to access telehealth since the start of this crisis. This means 7 million people have been able to avoid the risk of COVID -19 transmission between practitioners, and patients, through the expansion of the Telehealth system. However these items are due to expire on 30 September 2020. So far there has been no announcement from the Australian Government indicating whether these items will continue, rendering vulnerable Australians who are accessing these services unsure whether vital treatment will continue.
“This is a dangerous situation in a dangerous time,” says Sarah McMahon, Psychologist and Director of BodyMatters Australasia. “Telehealth has enabled vulnerable Australians to access critical allied health treatment that would otherwise be unavailable to them. These Australians are now unsure whether this treatment will continue, adding to their distress.
Four reasons why these services are critical:
1. Telehealth enables increased accessibility of treatment
Access to healthcare is a fundamental human right. However historically allied health treatment has required patients to physically visit a practitioner’s office to access a Medicare rebate. Consequently, treatment has not been available to all Australians as there are many legitimate reasons why a person may have not been able to attend a practitioner’s office. These include the tyranny of distance and geographical barriers, mobility issues experienced by individuals, and practical barriers such as overwhelmed new mums or people with severe anxiety or depression who experience
difficulty leaving the house. An additional barrier now exists with COVID, which is that for people who have compromised immunity or who care for other vulnerable individuals. For these people, leaving the house may be tantamount to a death sentence. Further, in terms of the stretched and limited capacity of most practitioners currently, Telehealth enables flexible service delivery, including temporary scaling up beyond office space limitations to service long wait lists. Enabling ongoing access to Medicare rebates for Telehealth services is paramount for the continuation of care for all of these people who will not have access if these changes end.
2. Telehealth enables excellent treatment outcomes
There is no clinical reason for ceasing access to Telehealth. Research suggests that in cases where Telehealth is clinically indicated, treatment outcomes are excellent. Further, utilising Telehealth enables greater access to treatment including earlier intervention, access to niche services that are not geographically close and access to practitioners in other locations when access to practitioners in a particular region is saturated, such as during a lockdown period. These also improve public health and treatment outcomes. We know that public mental health will be a long term casualty of COVID. Enabling ongoing and unrestricted access to Medicare rebatable treatment via Telehealth will enable positive treatment outcomes to continue. In a recent study of the Health Forum of Australia in May* “it found that 80% of those who were offered telehealth services used it, of these a similar proportion viewed the service a sexcellent or good quality”. These figures show how important it has been to be innovative in service delivery in times of a pandemic such as this, which involves people’s
3. Continuing Telehealth reduces costs for Medicare
Enabling these items to continue will not add costs to Medicare. Indeed, reliable access to Medicare rebatable sessions via Telehealth will improve access to allied health treatment, decreasing psychological conditions and improving societal wellbeing thus reducing the burden on the public health system. It will also reduce suicide rates and enable our population to be more resilient during consequences of COVID such as unemployment and recession. It will also prevent overuse of the hospital system, eliminating some of the pressure on the emergency departments – as clients can have access to any Allied Health Practitioner outside of the hospital system, under a telehealth rebate – which means access is available for everyone. This will have a direct impact on Australia’s recovery as a nation.
4. Telehealth protects practitioners from contracting COVID and enables continuity of care
Face to face treatment increases the risk of developing COVID. It typically occurs in a small, enclosed room for 50 minutes. Physical distancing may be impossible and wearing face masks may not protect against the transmission of COVID as a result. Enabling Telehealth items for an extended period of time enables allied health practices to be agile and autonomous in their implementation of their COVID Safe Plans. This is particularly important as it remains unclear how many months or years Australia will be managing cases of COVID. If they expire on 30 September there are many people who will be displaced from treatment. Extending these items means some level of continuity of care can continue.
Psychologists and other allied health providers agree that these items should continue indefinitely. COVID has accelerated changes in our efficiency and this increased accessibility to treatment is one excellent example of this.