The impact of telehealth policy changes on general practitioner consultation activity in Australia: a time-series analysis.

Objective: To examine the impact of telehealth policy changes on general practitioner (GP) consultation activity in Australia, during the coronavirus disease 2019 (COVID-19) pandemic, from January 2019 to December 2021. Methods: An interrupted time-series analysis was conducted to analyse the impact of two major policy changes, introduced through the Medicare Benefits Schedule (MBS), on GP consultation (in-person, videoconference, telephone) activity. The first policy change was the introduction of additional COVID-19 telehealth funding through the MBS on 30 March 2020. The second policy change was the limitation on telephone consultation length to under 20 min on 1 July 2021. The rate of GP telehealth provision and activity was compared between pre-and post-intervention periods, separated by these MBS policy changes. Results: After the first policy change, there was a significant increase in telehealth provision, with a simultaneous decrease in in-person consultations (P < 0.0001). However, telehealth provision decreased in the months following this first policy change (P < 0.0001), while in-person activity increased. After the second policy change, the initial videoconference provision increased (P < 0.0001). However, all telehealth activity decreased afterwards. In the months following the second policy change, the decrease in monthly activity for in-person (P = 0.700), telephone (0.199) and videoconference (P = 0.178) consultations was not significant. Conclusions: The introduction of additional telehealth funding and limitations on telephone consultation length encouraged the initial provision and growth of telehealth services. However, these policy changes did not sustain the long-term upward trajectory of telehealth activity. Telehealth policies should increase opportunities for appropriate and sustainable GP telehealth services. What is known about the topic? The COVID-19 pandemic was a catalyst for increased telehealth provision by general practitioners (GPs). Since COVID-19, the Australian Government have invested in telehealth by increasing reimbursement opportunities through the Medicare Benefits Schedule (MBS) and making multiple telehealth policy changes. What does this paper add? This study examined the impact of MBS telehealth policy changes on GP consultation activity in Australia over 3 years during COVID-19. What are the implications for practitioners? Telehealth funding is necessary for service viability. However, funding alone is unlikely to encourage increased videoconference use and is unlikely to promote long-term telehealth provision. Future telehealth policies should increase opportunities for appropriate and sustainable GP telehealth services. [ABSTRACT FROM AUTHOR]