Patient group and cardiologists call for reform of Medicare-funded heart checks

Latest News

A leading patient group is uniting with clinicians during Heart Valve Disease Awareness Week to express concern and call for reform of Medicare-funded items for heart checks.

They say current arrangements are a risk for patients living with less well-known heart conditions.

Heart valve disease is a chronic condition that affects more than half a million Australians. The ageing population and underdiagnosis are key drivers of its increasing prevalence.

hearts4heart CEO and founder Tanya Hall says interim heart health check Medicare item numbers - 699 and 177 - were introduced on 1 April 2019.

These items allow patients to receive a cardiovascular disease assessment from a GP or another medical practitioner. However, they are currently under review and are due to expire in June.

Ms Hall said this concerning situation is made worse by the fact patients cannot receive a Medicare-funded heart health assessment if they have received a separate medical assessment service in the previous 12 months.

She said there needs to be greater synergy between health assessments.

There were 130,853 Medicare items processed for item 699 from January to November 2022. However, Ms Hall said many GPs are not providing the MBS Heart Health Check because auscultation is not included and it restricts them from claiming other separate Medicare health assessments.

“It is great to see health assessments focused on heart disease prevention, but it is not practical to have a health assessment that focuses on one disease in isolation. There are many different types of heart disease, and focusing primarily on cardiovascular disease overlooks patients at risk of other heart conditions, such as heart valve disease,” said Ms Hall.

“Claiming the MBS heart check should not exclude GP’s from claiming a separate Medicare health assessment service, because patients often have co-morbidities,” she said.

“Our healthcare system should be holistic and focus on prevention - earlier detection and treatment once heart disease is detected saves lives, reduces healthcare costs, and improves economic productivity,” said Associate Professor Dion Stubbs, a cardiologist at Alfred Hospital.

“A simple first step to achieving this is to introduce a simple stethoscope check as a requirement in health assessments, because it can be used to check for symptoms of various heart diseases, including heart valve disease, atrial fibrillation, and heart failure.”