Fair access General Practice Mental Health Video Consultations

What is the Modified Monash Model and why is it important?

The Modified Monash Model (MMM) was developed in 2015 by the Department of Health to address the disparities in health service access that exist across Australia.

The model is based on the ‘Australian Statistical Geography Standard – Remoteness Areas (ASGS-RA)‘ existing classification system, which uses census data to segment 5 categories of remoteness, yet further subdivides regional Australia based on the size of local towns or cities.

Australian Statistical Geography Standard – Remoteness Areas (ASGS-RA):

Modified Monash model AustraliaModified Monash Model Australia

The Modified Monash Model:

Modified Monash Model - areas 6 and 7 receive government funding for telehealth services

Modified Monash Model-  receive medicare reimbursements for telehealth

Essentially, the MMM is used to offer various financial incentives that aim to attract and retain medical staff in rural and remote areas.

For example, the Home Care Viability Supplement is paid monthly to aged care providers in eligible areas, in order to cover the higher costs of delivering their services in these areas. MMM classifications between 3 and 7 can receive various payment amounts.

In a similar way, the National Disability Insurance Agency allows healthcare providers to claim travel time at the hourly rate when making personal home visits, ranging from 20-45+ minutes.

In terms of telehealth, the Australian Government uses the MMM to identify patients and providers that are eligible for Medicare rebates under the Better Access Scheme. Patients that have a Mental Health Treatment Plan and are located in MMM classifications 4-7 are eligible to claim their Medicare rebates on all 10 video consultation sessions. These services can be delivered by appropriate psychologists, social workers or occupational therapists that are registered with Medicare.

In turn, the psychologist, social worker, or occupational therapist appropriately registered to provide mental health services may also now claim reimbursement from Medicare when serving patients under the Better Access Scheme. In order to do so, the patient must:

  • Have both an audio and visual link with the allied health professional. If both audio and video links cannot be established, the provider cannot claim the service through Medicare. Claims cannot be made for telephone or email services.
  • Be located in MMM regions 4-7.
  • Be located at least 15km by road from the treating provider at the time of consultation.

As of September 2018, allied health professionals can deliver all 10 eligible services in a calendar year via telehealth, which is a change from the previous requirement of one face-to-face consultation in the first four telehealth sessions. Please note, practitioners cannot claim telehealth attendance items for services provided to admitted hospital patients, including hospital-in-the-home patients.

The Better Access Scheme, taking advantage of the MMM model, allows providers in urban and regional centres to expand their practice to patients chronically lacking access.

Recently,  $33.5 million dollars was also announced to be allocated to telehealth funding over three years to provide access to GP services via video for those living in the Modified Monash Model areas 6 and 7, suggesting Medicare rebates will soon be available for these sessions.

Image Source: CarbonBrief, Doctor Connect