Uptake, utilisation and costs of treatment through Better Access from 2018 to 2022: An analysis of Medicare Benefits Schedule data.

objectiveAustralia's Better Access initiative enables Australians with mental disorders to receive sessions of evidence-based psychological treatment following referral from an eligible provider (usually a general practitioner), subsidised through Medicare. As part of a commissioned evaluation, we examined patterns of Better Access treatment.

methodsWe sourced aggregated Medicare Benefits Schedule data from Services Australia on Better Access services delivered from 1 January 2018 to 30 June 2022. From this, we developed profiles of Better Access treatment over time and according to key consumer characteristics.

resultsIn 2021, over 1.3 million Australians received at least one treatment session subsidised through Better Access (up by 0.9% per year since 2018). People living in medium/high socioeconomic status areas within major cities, females and young adults were more likely to receive Better Access treatment compared to other groups. Consumers made an out-of-pocket payment for two-thirds (64.8%) of treatment sessions in 2021 (vs 52.7% in 2018). The median out-of-pocket payment per session was constant between 2018 and 2021 ($74) but increased to $90 in the first half of 2022. In 2021, 29.9% of fees charged for all treatment sessions nationally came from consumer out-of-pocket payments (vs 24.5% in 2018). Fewer people accessed treatment following referral in 2021 than in 2018 (58.8% vs 66.9%), and those who did waited longer until their first session (median 22 days in 2021 vs 18 days in 2018).

conclusionBetter Access enables many Australians to receive psychological treatment. Efforts are required to address gaps in access and increased wait time and consumer costs.