Health assessments play a vital role in the proactive management of patient health, providing an opportunity for early detection of potential issues and the implementation of preventative measures. Despite this, recent findings from the Medicare Benefits Schedule (MBS) Health Assessment Review have highlighted significant gaps in the utilisation of these assessments across Australia. The review not only identifies these issues but also proposes crucial changes to improve the effectiveness and uptake of health assessments. Understanding the role of specific sub-components within these assessments, as well as aligning with current clinical guidelines, is essential for maximising their impact.

The Importance of Targeted Health Assessments

The MBS Health Assessment Review reveals that, while many health assessments include evidence-based components, there is often a misalignment with up-to-date clinical guidelines. This misalignment can lead to missed opportunities for early intervention and a reduction in the overall effectiveness of the assessments. However, the report highlights that certain sub-components of health assessments are particularly effective when applied in a targeted manner, according to clinical guidelines.

For example, Cardiovascular Risk Assessments involve screening for blood pressure, cholesterol levels, and other risk factors that are crucial for preventing heart disease. These assessments are especially effective when focused on individuals at higher risk, such as those with a family history of cardiovascular disease or lifestyle factors that increase their risk. Similarly, Diabetes Screenings use blood glucose tests to identify individuals at risk of diabetes or pre-diabetes. Early detection through these screenings is essential for managing and preventing the progression of diabetes, particularly in populations with a higher predisposition to the disease.

Other valuable sub-components include Mental Health Assessments, which screen for conditions like depression and anxiety, Vaccination Status Checks, which ensure that patients are up-to-date with their immunisations, and Lifestyle Assessments, which evaluate factors such as diet, physical activity, and smoking status. These assessments are all highly effective when used with specific populations or for particular conditions, as they allow for tailored interventions that directly address the patient's health risks.

The effectiveness of these sub-components is closely tied to their alignment with clinical guidelines. In Australia, several authoritative bodies provide these guidelines:

• The National Health and Medical Research Council (NHMRC) publishes guidelines on chronic disease management, preventive care, and specific conditions like diabetes and cardiovascular disease. These guidelines are based on the latest research and provide a framework for effective patient care.

• The Royal Australian College of General Practitioners (RACGP) issues guidelines for general practice, covering a wide range of topics, including preventive health assessments, chronic disease management, and mental health care.

• The Australian Government Department of Health also provides guidelines, particularly those related to public health initiatives and preventive care. These guidelines are essential for ensuring that health assessments are both current and relevant to the needs of the population.

• In some cases, Australian guidelines may reference international standards from organisations like the World Health Organisation (WHO) or the American College of Cardiology, especially when local guidelines are still under development or revision.

Aligning health assessments with these guidelines ensures that the assessments are based on the most current and evidence-based practices, leading to better patient outcomes.

Key Findings from the MBS Health Assessment Review

As well as discovering misalignments current clinical guidelines, the review highlights several other critical issues in health assessments, including their low uptake. For instance, only about 3-5% of eligible individuals received a time-based health assessment in the 2023 financial year, with uptake rates even lower in remote areas. Additionally, less than 25% of the eligible First Nations population accessed a health assessment in FY23, with the likelihood of receiving an assessment decreasing as patients age. These disparities indicate a significant gap in care, particularly for vulnerable populations.

Proposed Changes to Improve Health Assessments

To address these issues, the review proposes several important changes:

1. Better Alignment with Clinical Guidelines: Updating clinical requirements to ensure that health assessments reflect the latest evidence-based practices. This includes revising the scope of assessments to match current guidelines.

2. Expanding Access: Allowing other healthcare professionals, such as nurse practitioners, to conduct health assessments could alleviate the burden on general practitioners and improve accessibility for patients.

3. Linking Health Assessments to MyMedicare: Integrating health assessments with MyMedicare could streamline the process of identifying eligible patients and ensure that assessments are consistently offered to those who need them most.

4. Adjusting Age Cohorts and Service Frequency: Revising the age groups and frequency of assessments for chronic disease and type 2 diabetes to better align with clinical guidance, ensuring that patients are monitored more effectively.

5. Introducing Targeted Assessments: Considering new assessments for high-risk groups, such as individuals being released from prison or children in out-of-home care, could help address specific health risks in these populations.

In summary, the MBS Health Assessment Review underscores the urgent need to prioritise health assessments as a routine part of patient care. By implementing the proposed changes and ensuring that assessments are aligned with the latest clinical guidelines, healthcare providers can significantly improve patient outcomes. This proactive approach to health management has the potential to reduce the burden of chronic disease and enhance the overall health of the Australian population.

Healthcare providers must leverage tools like Cubiko, Primary Sense, and Best Practice Software to identify eligible patients and encourage participation in health assessments. By doing so, we can close the gaps in care and ensure that every patient has the opportunity to benefit from early detection and targeted interventions.