Performance Information for Administered Items -
Access through Medicare to cost-effective medical services, medicines and acute health care for all Australians, including:
national insurance for medical services through the Medicare Benefits Schedule;
Measure
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Result
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Quantity:
Rebates will be provided for an estimated 223 million Medicare services.
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Rebates were provided for an estimated 221 million Medicare services.
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Quantity:
Rebates will be provided for an estimated 11.4 Medicare services per capita.
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Rebates were provided for an estimated 11.1 Medicare services per capita.
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alternative funding for General Practice;
Measure
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Result
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Quantity:
The number of practices taking up the outcomes based elements of the Practice Incentives Program (such as diabetes, cervical screening and participation in activities approved by the National Prescribing Service).
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The majority of practices in Australia participate in the Practice Incentives Program (PIP). At May 2003, there were 4,593 practices participating, providing 78% of all care provided to patients nationally.
As at May 2003:
31% of PIP practices participated in the quality prescribing incentive; and
12% of PIP practices were paid for providing teaching sessions.
In November 2001 new initiatives for asthma, cervical screening and diabetes were introduced. As at May 2003, PIP practice participation in these initiatives was 86%, 88% and 87% respectively.
The outcome component of the Diabetes initiative was introduced in May 2003 with 40% of eligible PIP practices receiving payments.
In July 2002, a new incentive for mental health was introduced with 1,957 providers participating at May 2003.
66% of eligible PIP practices participated in the practice nurses incentive.
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Quantity:
The proportion of Australian Government funding for general practice provided through the Practice Incentives Program.
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8% of Australian Government funding for general practice was provided through the PIP in 2002-03.
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development and support of other medical services related to the Medicare Benefits Schedule.
Measure
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Result
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Quality:
100% of new medical services listed for funding under the Medicare Benefits Scheme have been assessed for evidence of safety, effectiveness and cost-effectiveness (see also Departmental Output Group 2).
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All new medical services listed under the Medicare Benefits Schedule (MBS) were reviewed by the Medical Services Advisory Committee (MSAC) for safety and effectiveness prior to listing. MSAC also undertook economic analysis of all new listed services except for those relating to positron emission tomography which are being funded under special arrangements to further evaluate their effectiveness and cost effectiveness.
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national insurance for access to medicines through the Pharmaceutical Benefits Schedule;
Measure
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Result
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Quantity:
An estimated 166.6 million Pharmaceutical Benefits Scheme prescriptions will be supplied for general and concessional patients.
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The number of prescriptions issued in 2002-03 subsidised by the Australian Government under the Pharmaceutical Benefits Scheme (PBS) was 158.5 million. This compared with 154.5 million in 2001-02.
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Quantity:
An estimated 8.4 Pharmaceutical Benefits Scheme prescriptions per capita will be supplied.
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The average number of PBS scripts supplied per capita was 8.0 for the year, compared with 7.8 for the previous year.
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Efficiency:
Total cost of price increases to Pharmaceutical Benefits Scheme drugs approved by the Pharmaceutical Benefits Pricing Authority compared with the $2.8 million increase in 2001-02.
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Price increases as a result of Pharmaceutical Benefits Pricing Authority recommendations amounted to $5.3 million in 2002-03 compared with $3.1 million in 2001-02. Although the level of price increases was relatively low, Australian Government costs overall have increased substantially due to new listings and the transfer in prescribing to new, more expensive drugs.
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development and support of services related to the Pharmaceutical Benefits Schedule; and
Measure
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Result
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Quantity:
Percentage of Pharmaceutical Benefits Scheme benefits paid for pharmaceuticals listed following evidence based assessment of comparative effectiveness and cost.
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In 2002-03 there were 649 drugs listed on the PBS of which 44% have been subjected to evidence-based assessment (See Figure 2.6 on page 107). Of all drugs listed on the PBS, all (100%) valid prescriptions were paid.
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Efficiency:
Pharmacist remuneration as a proportion of Pharmaceutical Benefits Scheme outlays.
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In 2002-03, pharmacist remuneration was 25.0% of the Australian Government cost of the PBS compared to 25.9% of the Government cost of the PBS in 2001-02.
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access to public hospital services for public patients.
Measure
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Result
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Quality:
All States and Territories maintain, or improve, their performance levels for emergency department and elective surgery waiting times at no less than 1 July 1998 levels.
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See Tables 2.3 and 2.4 (see pages 108 and 109), which provide the most recent data for 2001-02.
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Quantity:
An estimated national average of 293.27 public patient weighted separations per 1,000 applicable weighted population.
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Under the 1998-2003 Australian Health Care Agreements, States and Territories are required to provide annual morbidity unit record data 6 months after the end of the financial year. This data is used to measure the level of admitted public patient activity according to the number of public patient weighted separations per 1,000 applicable weighted population. The most recent morbidity unit record data available is for 2001-02. Against a performance measure for 2001-02 of an estimated national average of 287.24 public patient weighted separations per 1,000 applicable weighted population, on the data currently available the achievement was a national average of 281.2 public patient weighted separations per 1,000 applicable weighted population.
| Performance Information for Departmental Outputs -
Policy Advice, including:
implementation of 2002-03 Budget measures;
development of 2003-04 Budget measures that contribute to Government’s health and fiscal objectives;
advice to the Minister on financing arrangements in health;
consideration of future directions for Medicare Benefits Schedule and Pharmaceutical Benefits Scheme; and
Australian Government approach to the negotiation of the new Australian Health Care Agreements with the States and Territories.
Measure
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Result
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Quality:
A high level of satisfaction of the Ministers, Parliamentary Secretary and Ministers’ Offices with the relevance, quality and timeliness of policy advice, Question Time Briefs Parliamentary Questions on Notice and briefings.
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The Minister and Minister's Office were satisfied with the relevance, quality and timeliness of policy advice, Question Time Briefs, Parliamentary Questions on Notice and briefings.
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Quality:
Agreed time frames are met for responses to ministerial correspondence, Question Time Briefs, Parliamentary Questions on Notice and ministerial requests for briefing.
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Agreed time frames were met for:
85% of ministerial correspondence;
94% of Question Time Briefs;
85% of Parliamentary Questions on Notice; and
84% of ministerial requests for briefing.
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Quality:
A high level of stakeholder satisfaction with the quality and timeliness of departmental/portfolio inputs to national policy, planning and strategy development and implementation.
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Key departmental stakeholders are satisfied with the quality and timeliness of the Department’s policy advice. For example:
extensive policy development, consultation and liaison occurred throughout the year with the Committee for Incentives for Mental Health (now, the Better Outcomes Implementation Advisory Group), the HIC and within the Department. This ensured the successful implementation of the MBS Focussed Psychological Strategies item, as part of the Better Outcomes in Mental Health Care initiative for 2001-02; and
stakeholders in the Enhanced Primary Care Medicare items were consulted as part of the independent evaluation of the items and the associated GP Education, Support and Community Linkages program, conducted through 2001 and 2002.
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Quality:
A high level of stakeholder satisfaction with relevance, quality and timeliness of information and education services.
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Advice provided by the Department is generally provided in a timely manner. For example:
education and consultation campaigns are developed in close consultation with stakeholders. Information campaigns conducted under Outcome 2 throughout the year were generally successful and stakeholders are satisfied with their relevance, quality and timeliness;
in April 2003 the Department released an information kit on the EPC Medicare items aimed at workers involved in Indigenous health—Looking after our People. The kit has been well-received by stakeholders in Indigenous health; and
stakeholders have expressed a high level of satisfaction with the training, support and information provided at the MediConnect field test sites.
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Quality:
Timely production of evidence-based policy research to inform and engage stakeholders in meaningful policy and program discussion.
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The Department continues to engage stakeholder groups in discussion of new policy and program initiatives under Outcome 2. For example:
timely, evidence-based information was provided to GP peak bodies to facilitate development of the General Practice Electronic Decision Support initiative; and
implementation of policy changes (from 1 July 2003) and their implications have been undertaken, in consultation with the medical profession through representation on the GPII Advisory Group at regular meetings.
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Quantity:
4,400-4,500 responses to ministerial correspondence, 210-230 Question Time Briefs, 25-35 Parliamentary Questions on Notice and 75-85 ministerial requests for briefings.
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There were approximately:
4,308 items of ministerial correspondence items processed;
362 Question Time Briefs prepared;
53 responses to Parliamentary Questions on Notice; and
106 ministerial briefings prepared.
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Program management, including:
managing the Medicare Benefits Schedule and Pharmaceutical Benefits Scheme estimates;
making payments to the States and Territories under the Australian Health Care Agreements;
financial management and reporting on Outcome 2;
managing funds provided to the Health Insurance Commission for Medicare services under the Output Pricing Agreement (OPA) (see Output 3);
management of contracts to support policy development;
administration of grant programs;
successful management with the Health Insurance Commission of the further development of the Better Medication Management System;
successful implementation of Budget initiatives;
Measure
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Result
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Quality:
Budget predictions are met and actual cash flows vary less than 5% from predicted cash flows.
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Actual expenses for Outcome 2 were $20.911 billion compared to a predicted $21.051 billion. Overall expenses were 99.34% of estimates.
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Quality:
100% of payments are made accurately and on time or payments are made in accordance with negotiated service standards.
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All payments required to be made in respect of the Department’s contractual obligations were made on time including payments to:
practices under the PIP and GPII were made by the HIC in accordance with the relevant schedules to the Strategic Partnership Agreement; and
the States and Territories under the Australian Health Care Agreements.
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Quality:
Further development of the Better Medication Management System for Australia, with full stakeholder support.
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Since its inception, the Better Medication Management System (now known as MediConnect) has been developed in close consultation with stakeholders, including involvement of advisory groups having representation from key medical, pharmacy and consumer organisations. Development has now progressed to the field test stage with full stakeholder support, including selection of the field test sites in Launceston and Ballarat. Local stakeholder support has been actively engaged in both locations. The first field test commenced in Launceston in March 2003.
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Quantity:
Approximately 80 grants, 45 consultancies/contracts and 40 funding agreements administered (based on 2001-02 figures).
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Total agreements administered in 2002-03:
97 grants;
127 consultancies/contracts; and
171 funding agreements.
The number of these that were new agreements:
94 grants;
88 consultancies/contracts; and
64 funding agreements.
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Efficiency:
Departmental expenses allocated to managing the agreement with the HIC as a percentage of Departmental expenses for the HIC Output Pricing Agreement to administer the Medicare Benefits Schedule and Pharmaceutical Benefits Scheme.
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The percentage was 0.064% ($258,871 compared to $406,716,471).
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ongoing development and maintenance of the Medicare Benefits Schedule; and
ongoing development and maintenance of the Pharmaceutical Benefits Schedule.
Measure
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Result
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Quality:
All applications for listing on the Pharmaceutical Benefits Scheme have been assessed for evidence of safety, effectiveness and cost effectiveness.
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Measure met. All applications for listing on the PBS in 2002-03 were assessed for evidence of safety, medical effectiveness and cost effectiveness.
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Quality:
All new medical services listed in the Medicare Benefits Schedule have been assessed for evidence of safety, effectiveness and cost effectiveness.
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Measure met. All new medical services listed under the MBS were reviewed by the Medical Services Advisory Committee (MSAC) for safety and effectiveness prior to listing. MSAC also undertook economic analysis of all new listed services. In 2002-03 the Minister endorsed 6 reviews relating to potential new listings on the MBS and 5 reviews referred within the Department. A further 9 reviews were considered by MSAC but are yet to be finalised.
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Quality:
Time taken to assess applications to the Medical Services Advisory Committee for public funding new medical services will be reduced from the average of 11 months to assess applications finalised in 2001-02.
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The average time taken to assess applications in 2001-02 was 15 months as reported in 2001-02 Annual Report, compared with 18 months in 2000-01. For 2002-03 the average time taken to assess applications has been reduced to 14.9 months.
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Quality:
Time taken to process new applications for listing in the Pharmaceutical Benefits Scheme Schedule. In 2000-01 all applications received by the due date were dealt with by the next PBAC meeting. All positive PBAC recommendations were dealt with by the next Pharmaceutical Benefits Pricing Authority meeting.
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In 2002-03 all applications for listing a medicine on the Pharmaceutical Benefits Scheme received by the due date were processed by the Department within the agreed timeframe (ie 11 weeks from lodgement of the application to consideration by the PBAC). All positive PBAC recommendations were dealt with by the next Pharmaceutical Benefits Pricing Authority meeting.
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Quantity:
Number of new listings on the Medicare Benefits Schedule. There were 578 new listings in 2001-02.
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There were 129 new MBS listings in 2002-03. The number of new items introduced in 2001-02 was unusually high due largely to the implementation of the Relative Value Guide for Anaesthetists and assorted attendance items. The number of items introduced on 2002-03 returned to a more usual number of new listings.
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Quantity:
Item descriptors amended on the Medicare Benefits Schedule. There were 189 descriptors amended in 2001-02.
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There were 145 MBS descriptors amended in 2002-03.
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Quantity:
Number of new listings on the Pharmaceutical Benefits Scheme. There were 111 new items and 238 new brands in 2001-02.
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There were 87 new items and 181 new brands listed on the PBS in 2002-03.
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Quantity:
Number of listings amended on the Pharmaceutical Benefits Scheme. There were 103 listings amended in 2001-02.
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There were 87 listings amended in 2002-03.
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development of information activities. Proposed information activities for 2002-03 include:
a consumer, evidence based, education strategy regarding safe and correct use of medicines;
Measure
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Result
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Quality:
Information campaigns conducted during the year are evaluated as being effective.
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An information strategy which provides education and information materials on appropriate use of generic medicines for health professionals and consumers has been undertaken as part of the measure to Facilitating the Use of Generic Medicines. The effectiveness of the strategy has not been evaluated as yet.
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Quality:
A high level of stakeholder satisfaction with the relevance, quality and timeliness of information and education services.
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An information kit on the Enhanced Primary Care Medicare items aimed at workers involved in Indigenous health—Looking after our People—was released in April 2002. The kit has been well received by stakeholders in Indigenous health.
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Quantity:
An estimated 50,000 calls to the Pharmaceutical Benefits Scheme information line.
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28,260 calls were received by the Pharmaceutical Benefits Scheme Information Line. Of these 28,248 (99.95%) were satisfied with the information given, 6 (0.025%) were dissatisfied and 6 (0.025%) were abusive. The estimate was based on proposed increases to patient co-payments and safety net thresholds. As legislation was blocked in the Senate, the PBS Information Line did not receive the number of calls expected.
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production of the Medicare Benefits Schedule (and supplements) covering more than 4,000 individual items;
production of the Pharmaceutical Benefits Scheme schedule (and supplements) covering approximately 2,500 individual drug items; and
Measure
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Result
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Efficiency:
Real change in publication costs of Medicare Benefits Schedule and Pharmaceutical Benefits Scheme schedules over previous year.
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The MBS publication cost for 2002-03 was $619,574 compared to $626,149 in 2001-02, a 1.1% decrease. The PBS publication cost for 2002-03 was $1,041,069 compared to $963,941 in 2001-02, an 8% increase (half the 2000-01 to 2001-02 increase).
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Quality:
Production of the Medicare Benefits Schedule by 1 November 2002.
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The Medicare Benefits Schedule was produced before 1 November 2002 and distributed on time.
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Quality:
Revision of the Pharmaceutical Benefits Schedule by 1 August 2002, 1 November 2002, 1 February 2003 and 1 May 2003.
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Issues of the Schedule of Pharmaceutical Benefits were produced in August 2002, November 2002, February 2003 and May 2003 and distributed on time.
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continued implementation of the Australian Health Care Agreements, the Diagnostic Imaging Agreement, the Pathology Agreement and the Community Pharmacy Agreement.
Measure
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Result
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Quality:
A high level of stakeholder satisfaction with the timely development and implementation of national strategies.
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As a result of the successful collaborative working relationship with the key diagnostic imaging stakeholders in the past, the Australian Government has entered into 4 new 5-year agreements with the 5 main providing specialties of diagnostic imaging services, which commenced on 1 July 2003.
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Quantity:
Number of States and Territories signed up for Pharmaceutical Benefits Reforms under the Australian Health Care Agreements.59
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This reform allows states to use the Pharmaceutical Benefits Scheme in public hospitals for patients upon discharge and for non-admitted patients. The reforms will also provide the Australian Government subsidised access to expensive cancer chemotherapy drugs for day admitted patients.
In 2002-03 the Australian Government reached agreement to vary the Australian Health Care Agreements with both Queensland and Western Australia. This brings the total number of States to 3 following agreement in 2001-02 with Victoria.
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Agency specific service delivery, namely services delivered to the Department by the Health Insurance Commission under the Output Pricing Agreement in relation to the Medicare Benefits Schedule and Pharmaceutical Benefits Scheme, being eligibility assessments, payment of benefits, education and compliance activities:
continue to develop the Strategic Partnership Agreement with HIC and ensure the Department’s relations with the HIC reflect the spirit of the Agreement.
Measure
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Result
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Quality:
Health and HIC chief executives are satisfied with this performance result, advised to them annually by the Health-HIC Strategic Partnership Management Committee.
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The Health-HIC Strategic Partnership Committee reports that the strengthening of the consultation arrangements has continued, resulting in improvements in most areas of coordination and cooperation. The Committee also noted that both agencies are working together to fulfil their shared reporting responsibilities.
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Quality:
High level of client satisfaction with the services provided by HIC.
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The annual HIC customer satisfaction survey indicated a high degree of client satisfaction among consumers (93%), doctors (75%) and pharmacists (91%).
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Quality:
An estimated 53% of Medicare Benefits Schedule and 99% of Pharmaceutical Benefits Scheme claims will be processed electronically.
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An estimated 54% (preliminary figure) of Medicare Benefits Schedule and 99% of Pharmaceutical Benefits Scheme claims were processed electronically.
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Quantity:
An estimated 425 million claims for Medicare Benefits Schedule and Pharmaceutical Benefits Scheme benefits to be processed.
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In 2001-02, 390.7 million claims were processed by the HIC for Medicare Benefits Schedule and Pharmaceutical Benefits Scheme benefits. In 2002-03 there were 394.8 million claims processes for Medicare Benefits Schedule and Pharmaceutical Benefits Scheme benefits. The estimated number of claims to be processed (425 million) was excessively high due to an error in the estimates provided for the 2002-03 Portfolio Budget Statements.
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Figure 2.6 Percentage of PBS drugs subject to cost effectiveness requirements
Table 2.3 Australian Health Care Agreements: 2001–02 Performance – Elective Surgery Waiting Times
Levels Achieved
New South Wales
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South Australia
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84% of Category 1 - within 30 days
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89% of Category 1 - within 30 days
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79% of Category 2 - within 90 days
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87% of Category 2 - within 90 days
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85% of Category 3 - within 12 months
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94% of Category 3 - within 12 months
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Victoria
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Tasmania
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100% of Category 1 - within 30 days
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72% of Category 1 - within 30 days
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79% of Category 2 - within 90 days
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51% of Category 2 - within 90 days
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90% of Category 3 - within 12 months
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66% of Category 3 - within 12 months
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Queensland
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Australian Capital Territory
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93% of Category 1 - within 30 days
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96% of Category 1 - within 30 days
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88% of Category 2 - within 90 days
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58% of Category 2 - within 90 days
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84% of Category 3 - within 12 months
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81% of Category 3 - within 12 months
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Western Australia
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Northern Territory
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87% of Category 1 - within 30 days
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88% of Category 1 - within 30 days
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74% of Category 2 - within 90 days
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77% of Category 2 - within 90 days
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92% of Category 3 - within 12 months
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91% of Category 3 - within 12 months
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Source: Data provided by the States and Territories under the Australian Health Care Agreements Notes;
Category 1 - admission within 30 days desirable for a condition that has the potential to deteriorate quickly to the point that it may become an emergency;
Category 2 - admission within 90 days desirable for a condition causing some pain, dysfunction or disability but which is not likely to deteriorate quickly or become an emergency; and
Category 3 - admission at some time in the future acceptable for a condition causing minimal or no pain, dysfunction or disability, which is unlikely to deteriorate quickly and which does not have the potential to become an emergency.
Table 2.4 Australian Health Care Agreements: 2001–02 Performance— Emergency Department Waiting Times
New South Wales
100% of Category 1 – immediately
78% of Category 2 - within 10 minutes
57% of Category 3 - within 30 minutes
60% of Category 4 - within 1 hour; and
86% of Category 5 - within 2 hours
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South Australia
99% of Category 1 – immediately
65% of Category 2 - within 10 minutes
50% of Category 3 - within 30 minutes
51% of Category 4 - within 1 hour; and
88% of Category 5 - within 2 hours
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Victoria
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Tasmania
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100% of Category 1 - immediately
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89% of Category 1 - immediately
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81% of Category 2 - within 10 minutes
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52% of Category 2 - within 10 minutes
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73% of Category 3 - within 30 minutes
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55% of Category 3 - within 30 minutes
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60% of Category 4 - within 1 hour; and
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57% of Category 4 - within 1 hour; and
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81% of Category 5 - within 2 hours
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89% of Category 5 - within 2 hours
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Queensland
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Australian Capital Territory
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99% of Category 1 - immediately
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100% of Category 1 - immediately
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71% of Category 2 - within 10 minutes
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87% of Category 2 - within 10 minutes
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56% of Category 3 - within 30 minutes
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80% of Category 3 - within 30 minutes
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59% of Category 4 - within 1 hour; and
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72% of Category 4 - within 1 hour; and
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80% of Category 5 - within 2 hours
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83% of Category 5 - within 2 hours
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Western Australia
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Northern Territory
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100% of Category 1 - immediately
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100% of Category 1 - immediately
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83% of Category 2 - within 10 minutes
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68% of Category 2 - within 10 minutes
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58% of Category 3 - within 30 minutes
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71% of Category 3 - within 30 minutes
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51% of Category 4 - within 1 hour; and
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62% of Category 4 - within 1 hour; and
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72% of Category 5 - within 2 hours
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82% of Category 5 - within 2 hours
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Source: Data provided by the States and Territories under the Australian Health Care Agreements Notes;
Category 1 - patients need resuscitation and require treatment immediately (eg cardiac arrest);
Category 2 - patients are deemed to be ‘emergencies' and require treatment within 10 minutes (eg chest pain);
Category 3 - patients are deemed to be ‘urgent' and require treatment within 30 minutes (eg moderate trauma);
Category 4 - patient are defined as ‘semi urgent' and require treatment within 1 hour; and
Category 5 - patients are defined as ‘non urgent' and require treatment within 2 hours.
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