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Improved Dental and Allied Health (provider information)

Overview

The Department of Veterans' Affairs (DVA) is reforming its dental and allied health service arrangements. These reforms were informed by a review (see Review of DVA Dental and Allied Health Arrangements — Final Report).

The reforms, announced in the 2018–19 Budget, has four main elements and will be implemented in a phased approach (see Budget 2018–19 fact sheet — Improved Dental and Allied Health).

Around 140,000 DVA cardholders who access DVA dental and allied health services will benefit through improved communication between GPs and allied health service providers, access to an expanded range of services, and opportunities for enhanced complex care management.

Further information can be found at the following frequently asked questions (FAQs) document:

Reform package: four main elements

1. Technical adjustments to the fee schedules

DVA is making technical adjustments to the dental and allied health fee schedules, to upgrade them to more contemporary industry standards.

Technical adjustments to the DVA fee schedules for dentists, dental specialists and dental prosthetists, are effective from 1 November 2018. The new fee schedules align more closely to the 12th edition of The Australian Schedule of Dental Services and Glossary issued by the Australian Dental Association. The list of changes are outlined below:

Technical adjustments to other selected allied health fee schedules will be made in coming months. DVA will consult with affected provider associations before implementing any changes.

2. A new treatment cycle for allied health services

Allied health treatment cycle arrangements now commencing on 1 October 2019

The Government has decided that the treatment cycle changes to allied health referrals will now be introduced on 1 October 2019.

The Government has recognised that DVA clients, allied health providers and general practitioners (GPs) need more support to ensure they understand and are able to manage the requirements of the treatment cycle.

The new 1 October start date will enable DVA to work closely with key stakeholders to address issues that have been identified in recent feedback. DVA will provide detailed information on the treatment cycle arrangements before they start.

Referral arrangements for Totally and Permanently Incapacitated (TPI) clients

During the recent Federal election, the Government announced that the treatment cycle does not apply to physiotherapy or exercise physiology services for DVA clients who have a Totally and Permanently Incapacitated (TPI) Gold Card.

As a result of this commitment, current referral arrangements will continue to apply for TPI clients for exercise physiology or physiotherapy services where these services are clinically necessary. The treatment cycle will apply for TPI clients for referrals to other allied health services.

How does the treatment cycle work?

From 1 October 2019, referrals for DVA clients to allied health services will be valid for up to 12 sessions or a year, whichever ends first. 

DVA clients can be referred by their usual GP to an allied health provider if they have a clinical need for allied health treatment. Referrals will be valid for up to 12 sessions or a year — whichever ends first.

At the beginning of the treatment cycle, the allied health provider will prepare a treatment plan and ask the client about their health goals. At the end of the treatment cycle the allied health provider will send a report to the client’s usual GP. The report outlines the treatment provided, the progress of the treatment and recommendations for further treatment if required.

The client’s GP will use this report to review the progress of their treatment and assess if further allied health treatment is clinically required, or whether other treatment options are needed. The GP will provide a new referral to the allied health provider if it is needed.

DVA clients will continue to have access to the care they need. Clients can have as many treatment cycles as their GP decides are clinically necessary.

DVA clients can have a separate treatment cycle for each allied health service they require. This includes having treatment cycles for different allied health services at the same time. For example, a client may have services provided by a dietician, podiatrist and physiotherapist at the same time.

Figure 1: Operation of the treatment cycle

See alternative text version, via link attached to this image.

3. Trials of new funding approaches

Depending on the outcomes of the treatment cycle, DVA will develop and design up to four trials of new funding approaches for allied health services. These trials will test alternative funding approaches for selected allied health provider groups to see if outcomes can be improved for clients.

For instance, many of the allied health schedules are based on the length of the consultation (time based). The trials will explore other approaches, such as a more case based approach that takes into account the type of treatment provided.

DVA will consult with provider associations before implementation of any changes.

The trials will start in 2021, subject to savings from an expected reduction in expenditure on allied health services.

4. Upgrades to allied health schedules

Depending on the outcomes of the treatment cycle, DVA plans to make further improvements to dental and allied health fee schedules to better reflect contemporary services and better support the workforce providing dental and allied health services.

Proposed changes include addressing the following:

  1. Use of new technologies.
  2. Reflecting new therapeutic techniques to address health problems.
  3. Consistency with industry standards in order to ensure that DVA fees schedules are up to date and to help reduce red tape for providers.
  4. Opportunities to make improvements for complex care management, for those at risk of suicide, those who are homeless, and those discharging from hospital.

These upgrades will start in 2021, subject to savings from an expected reduction in expenditure on allied health services.

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