An expert working group formed to review Medicare billing practices recommended that in some circumstances stent procedures should be removed from the Medicare rebate system,based on peer-reviewed studies showing they offered little benefit for people with mild symptoms,but the advice was not adopted after some cardiologists lobbied to keep the rebates in place.
Those voicing concerns stressed that stent procedures were a valuable clinical tool in many cases,and that the dispute among cardiologists centred specifically on whether they were being overused in cases where people only showed symptoms of mild or stable angina.
“I was disappointed and shocked,” said cardiologist and physician Dr Brett Forge,a member of the expert working group. “I just didn’t think they could do that because the evidence from the peer-reviewed literature is overwhelming.”
Precise figures on the number of stent procedures are not available,but cardiologists said the number runs into the tens of thousands around Australia per year,with up to half of those estimated to be performed on people with only mild symptoms.
‘In the context of Medicare falling apart and hospitals struggling to survive,we’re just wasting all this money.’
Dr Brett Forge,who was on the panel reviewing Medicare billing practices
The cost to the taxpayer via Medicare rebates varies greatly depending on the items claimed by doctors for types of stent procedure,hospital stays and some other factors,but one estimate put the average rebate at $2000. The overall cost of the procedure can be much higher,running into the tens of thousands of dollars per patient.
“In the context of Medicare falling apart and hospitals struggling to survive,we’re just wasting all this money,” Forge said. “It is an outrageous example of overservicing. But I suppose it’s just an example of how the system works. I think it’s just the tip of the iceberg.”