Program 2.1 provides access to general and specialist medical and dental services to entitled DVA beneficiaries. The department develops arrangements with medical and dental practitioners in both the public and private sectors to deliver a comprehensive range of services throughout Australia.
A priority for DVA in 2012–13 was to provide the veteran community with access to medical services that were responsive to their unique clinical needs. The department continued to monitor new developments in medical treatment and trends in veteran health needs, to ensure its policies and practices are meeting changing circumstances.
This is important as the veteran population is ageing and presenting with more complex health issues and as the contemporary veteran cohort is increasing.
In 2012–13, the overall number of clients accessing medical and dental services declined but the costs and breadth of those services increased, reflecting fee increases and greater demand for services per veteran.
DVA continues to work with health providers to reduce red tape and minimise costs around processing payments for veterans’ health treatments, aimed at making it easier for providers to do business with DVA.
|2012–13 PBS1 ($ million)||Estimated actual2 2012–13 ($ million)||Outcome 2012–13 ($ million)|
1 PBS in performance reporting tables means Portfolio Budget Statements.
2 Estimated actual means the estimated expense or total for 2012–13 provided in the 2013–14 Portfolio Budget Statements. As the Budget is released in May each year but the financial year does not close off until 30 June, the current year numbers in the Budget can only be estimates.
|2012-13 PBS||Estimated actual 2012-13||Outcome 2012-13|
|Treatment population||221 700||222 500||223 181|
Key performance indicators
|2012-13 PBS||Estimated actual 2012–13||Outcome 2012–13|
|Price: Unit cost per cardholder||$116||$105||$89|
Report on performance
Administered expenditure for medical and dental services in 2012–13 was $913.7 million, a small increase from the expenditure of $912 million last financial year. This was due to a combination of fee increases and the change in the number of services per veteran.
As at 30 June 2013, there were approximately 223 181 veterans who were eligible to receive treatment via a Repatriation Health Card (Gold or White Card). In 2012–13, a total of 211 395 clients accessed 11 million medical and dental services.
Compared with the previous year, there was a decrease in the number of veterans accessing medical and dental services, consistent with the decline in the veteran population.
However, there was an increase in demand for services and overall expenditure due to fee increases and the more complex health needs of the veteran community.
Number of medical services
Estimates are for approximately 10.5 million services for the full 2012–13 year.1 At the time of reporting, there were 10.2 million medical services provided in 2012-13 compared with 10.7 million at the same time of reporting in 2011–12. This will be a decrease on the actual number for 2011–12.
The administration cost per cardholder for 2012–13 is calculated using the staff and administration expenses (Program Support costs) divided by the eligible treatment population. The unit cost of $89 per cardholder for 2012–13 was lower than in 2011–12, and lower than estimated because there was a greater shift to online claiming than expected. Client numbers stayed higher than estimated and, due to administrative changes, unit costs were lower.
Average cost per medical service
Average cost per medical service increased this financial year. This reflected the broader range of services provided and the increases in fees paid to providers. The 2012–13 average is expected to increase slightly as further billing is received for services provided with in the financial year but not processed at the time of reporting.
Percentage of veteran population using medical services
In 2012–13,94.6 per cent of the veteran population used medical services, similar to the percentage reported in 2011–12.
Table 20 shows the number of medical services provided and average cost over the past five years as currently available in departmental data.
1 There is always a lag in obtaining the most up-to-date service counts because of the time taken by some providers to bill DVA.
|Number of services||12 319 077||11 793 638||11 450 995||10 941 515||10 225 275|
|Average paid per service||$67.86||$69.16||$70.43||$73.93||$75.53|
|Proportion of treatment population1||95.6%||95.5%||95.4%||95.1%||94.6%|
1 Treatment population is measured at 30 June for each financial year.
Number of dental services
There were 761420 dental services provided in 2012-13, compared with 755148 as at the same time of reporting in 2011–12. Current estimates are for 784270 services for the full year, a one per cent increase from the number now known for 2011–12.2
Average cost per dental service
The average cost per dental service has remained relatively consistent over the past few years but increased in the report year. The 2012-13 average is expected to increase once further billing data is received.
Percentage of veteran population using dental services
In 2012–13, 38 per cent of the veteran population used dental services, similar to the 38.5 per cent reported in 2011–12.
Table 21 shows the number of dental services provided and average cost over the past five years.
|Number of dental services||817 300||817 905||808 394||777 810||761 420|
|Average paid per service||$130.59||$128.55||$128.54||$128.58||$132.51|
|Proportion of treatment population1||38.2%||38.2%||38.4%||38.5%||38.0%|
1 Treatment population is measured at 30 June for each financial year.
Service items processed by the Department of Human Services
The Department of Human Services (DHS) processes payments for DVA to providers of medical, allied health and hospital services (refer to Program 2.2 for a full report on hospital services). A total benefit of $2.15 billion was paid by DHS to DVA providers in 2012-13, the same as the $2.15 billion paid in 2011–12.
Table 22 compares the number of items processed with the treatment population and average age at 30 June for the past five years, and the corresponding number of services per client in each year.
2There is always a lag obtaining the most up-to-date service counts because of the time taken by some providers to bill DVA.
|Processed||Treatment population||Average age||Services per client|
|2008–09||21.6 million||269 248||76.3||80|
|2009–10||21.7 million||260 513||76.4||83|
|2010–11||22.1 million||245 605||76.4||90|
|2011–12||21.2 million||233 800||76.2||91|
|2012–13||20.6 million||223 181||75.8||92|
Coordinated Veterans’ Care Program
The Coordinated Veterans’ Care (CVC) Program is now in its third year of operation and as at 30 June 2013, 18 683 Gold Card holders had been enrolled.
In December 2012 Grosvenor Management Consulting, engaged by DVA to independently evaluate the CVC Program, delivered the First Interim Evaluation Report to DVA, noting the CVC Program was performing well against the desired program outcomes able to be assessed at that point in time. Participating medical practitioners also reported very positive feedback about the model of care.
DVA continues to support the national Personally Controlled Electronic Health Record (eHealth record) initiative. Participants in DVA’s CVC Program and the telemonitoring trial will be encouraged to register for their eHealth record. Many in the veteran community have chronic conditions and complex care needs and, with the patient’s consent, eHealth records will support better, faster and easier sharing of important health information amongst health care providers.