• Print

All Aboriginal and Torres Strait Islander people are eligible for an annual Indigenous-specific health check: item 715 on the Medicare Benefits Schedule (MBS). This tool shows numbers and usage rates of the checks at various geographic areas. Charts and tables in the tool can be customised to show different time periods and, where possible, disaggregations by age and sex.

dynamic data display National and jurisdictional tool

dynamic data display Medicare Local and peer group tool

dynamic data display Primary Health Network tool


Source data: Excel download (1.5MB XLS)

Helpline: 1800 223 919 or .

Notes

Differences in usage rates across geographic levels should be interpreted with caution because the use of MBS 715 health checks is influenced by a number of factors which may vary by geographic areas, including:

  • access to MBS-billing GP services—MBS-billing services are not uniformly available across Australia, with people in remote areas more likely than those in other areas to have a greater reliance on non-MBS GP billing services
  • access to other primary health care—Indigenous people may receive regular comprehensive primary health care through other avenues or have established care arrangements, such as a chronic disease management plan
  • other regional differences—such as access to any GP services, regardless of whether or not they are MBS-billing services (see Number of services where GPs work).

The health check tool:

What’s new in this 5th release?

The 5th version of the health check data tool, which was released in July 2016:

  1. increased age disaggregation to 10 age groups for national and state and territory data (the only levels for which age and sex disaggregation are readily available)
  2. shows health check data for Australia and states and territories by calendar years, financial years and quarters up to 31 December 2015.

Medicare Local and Primary Health Network level data are reported up to 31 December 2014.

Age and sex data

Data on the age group and sex of Indigenous people who had a MBS item 715 health check are provided in the tool at the national and jurisdictional levels. Data by age and sex for other geographic levels are not available on the Medicare Australia Statistics webpage.

Closing the Gap

The Council of Australian Governments’ 2008 Closing the Gap reforms included commitments to close the gap in life expectancy between Indigenous and non-Indigenous Australians within a generation (by 2031) and to halve the gap in mortality rates for Indigenous children aged under 5 within a decade (by 2018). Ensuring and increasing access to the health check is an important part of achieving these commitments as the checks can have both direct health benefits and provide access to additional Indigenous-specific health measures.

The Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013–2023 also sets health check goals to be achieved by 2023.

Data sources

The sources of data presented in this tool are as follows.

  1. Numbers of health checks were sourced from, or based on, the Medicare Australia Statistics webpage. More information about these data is at MBS statistics and data suppression.
  2. Aboriginal and Torres Strait Islander population estimates are used in the tool to calculate usage rates; those estimates are based on 2011 Census counts. Different sources of population data were used depending on the geographical level of data being presented.

    At the national and jurisdictional levels, Indigenous population estimates produced by the Australian Bureau of Statistics (ABS) were used. The ABS estimates include population projections to 2026, with the Series B projections (which assume medium-level growth) used in this tool.

    At the Medicare Local, peer group and Primary Health Network levels, Indigenous population estimates and projections are based on, or sourced from, work undertaken by Prometheus Information Pty Ltd under contract to the Department of Health (see technical notes).

In addition, the tool provides information on the number of services where GPs work.

Data suppression

The Department of Human Services (DHS) suppresses some data at the Medicare Local level on the Medicare Australia Statistics webpage to ensure confidentiality of provider information. If data for at least one quarter are suppressed, DHS also suppresses the annual total number of health checks for that Medicare Local and this is not publicly released. Data suppression is not a common occurrence.

When data on the number of health checks are shown by quarter at the Medicare Local level, suppressed data are indicated in the tables with a dot for both the number of checks and usage rate, and in the graphs as missing data points for the relevant quarter.

Data suppression at the Medicare Local level may impact on the reports in the tool on the number of health checks at the Medicare Local, but also at the peer group level and Primary Health Network level. Reports presented at jurisdictional and national levels are not affected by data suppression.

Annual usage rates for Medicare Locals, peer groups and Primary Health Networks that were affected by suppressed data were estimated by the AIHW as outlined in the technical notes. Note that while usage rates were estimated, the numbers of health checks shown in the health check tool were not adjusted. Suppressed data for health check numbers, and annual usage rates that were affected by suppressed data, are noted in the Excel spreadsheets.

Geographic levels

The health check tool shows data for different geographical levels which have varying numbers of components:

Differences in usage rates across geographic levels should be interpreted with caution because the use of MBS 715 health checks is influenced by a number of different factors which may vary by geographic areas.

Health check data at the Medicare Local level are based on the medical provider’s address. This differs from health check data at the jurisdictional level which are based on the patient’s address. Thus if, for example, a patient lives in Queensland but gets a health check in New South Wales, the health check will be counted in the Queensland totals for jurisdictional reports, but counted in the New South Wales totals for Medicare Local reports. This means for Tasmania, the Australian Capital Territory and the Northern Territory (that is, jurisdictions that were also a single Medicare Local and are now a single Primary Health Network), the number of health checks may be different depending on whether the information is viewed in a jurisdiction report, or a Medicare Local or Primary Health Network report.

Health check: goals

The Indigenous Chronic Disease Package, implemented 2009-2013, aimed to increase health check uptake from about 10% (then the baseline) to 45% of adults over 4 years to 2012-13.

The Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013–2023 sets new goals for increasing Indigenous-specific health check uptake. By 2023:

  • for children aged 0–4, the goal is 69% (23% in 2015)
  • for children aged 5–14, the goal is 46% (18% in 2015)
  • for young people aged 15–24, the goal is 42% (17% in 2015)
  • for adults aged 25–54, the goal is 63% (23% in 2015)
  • for adults aged 55 and older, the goal is 74% (33% in 2015).

Indigenous health check (MBS 715)

All Aboriginal and Torres Strait Islander people, regardless of age, are eligible for an annual Indigenous-specific health check. This health check, listed as item 715 on the Medicare Benefits Schedule (MBS), was designed especially for Indigenous people. It was established because Indigenous people have considerably higher morbidity and mortality levels than non-Indigenous people, with earlier onset and more severe disease progression for many chronic diseases. The aim of the health checks is to provide Indigenous people primary health care matched to their needs by supporting early detection, diagnosis and intervention for common and treatable conditions.

Ensuring access to the health check is an important part of the Australian Government's commitments to Closing the Gap in both life expectancy and mortality. Use of health checks has increased substantially over time; nonetheless, only about 1 in 5 Indigenous people had such a health check in 2013–14. The AIHW Indigenous health check data tool aims to increase awareness, understanding and uptake of the health check among health care providers and Indigenous people.

The requirements of a health check, which are set out in the relevant section of the MBS, include an assessment of the patient’s health, including their physical, psychological and social wellbeing. The check also assesses what preventive health care, education and other help should be offered to the patient to improve their health and wellbeing. As at May 2015, the MBS rebate for a health check was $212.25. If the GP bulk bills this item, there is no charge to the patient. Health checks can be provided by any Medicare-billing GPincluding those in mainstream practices and those providing services mainly for Indigenous peopleand should generally be provided by the patient’s usual doctor.

The outcome of a health check may include access to other Indigenous-specific health measures. For example, if a GP identifies a need for follow-up care during a health check, they can give Indigenous people access to MBS-rebated follow up services from allied health workers, practice nurses and Aboriginal health workers.

For more information on the health check see the Department of Health.

Although all Indigenous people are eligible for a health check, there are a range of reasons why some people do not have one. For example:

  • Health checks are voluntary for both GPs and Aboriginal and Torres Strait Islander people, and not all Indigenous people or GPs may wish to participate.
  • Many Indigenous people and GPs may not be aware of the health check.
  • Mainstream general practices may not collect Indigenous status information for all patients (see Indigenous identification). If GPs are not aware of which patients are Indigenous, they cannot offer Indigenous-specific health measures such as the health check.
  • There is no requirement for GPs to bulk bill Indigenous people for the health check. Any fees charged to the patient can present a financial barrier for many Indigenous people.
  • Health checks may not be needed for Indigenous people receiving regular comprehensive primary health care through other avenues, or for those with an ongoing chronic disease with established care arrangements, such as chronic disease management plans.
  • Health care equivalent to a MBS 715 health check may be provided but not billed to Medicare for a variety of reasons (see non-MBS 715 health care).

Data on the number of health checks shown in this tool are the number of checks billed to Medicare in the relevant period, not the number of people who received a health check. That is, available data do not distinguish between a person receiving two health checks in one 12-month period and two different people receiving a health check in the same period. However, given these health checks are generally provided on an annual basis (although the minimum time allowed between checks is 9 months), the number of checks in a 12-month period is likely to be similar to the number of people receiving the checks.

Indigenous-specific health measures accessed via GPs

The main Indigenous-specific health measures which GPs provide directly, or provide access to, are:

  • health checks (MBS item 715)
  • follow-up services provided by a practice nurse or Aboriginal and Torres Strait Islander health practitioner for a person who had a MBS health check (MBS item 10987)
  • follow-up allied health services for a person who had a MBS health check (MBS items 81300–81360)
  • pneumococcal and influenza immunisations for Indigenous adults and other immunisations for Indigenous children in some states and areas
  • listings on the Pharmaceutical Benefits Scheme (PBS) for Indigenous people
  • cheaper medicines through the PBS co-payment measure
  • care coordination and expedited access to follow-up services and a range of medical aids provided through the Integrated Team Care Program (previously the Care Coordination and Supplementary Services program)
  • outreach health services provided by GPs, specialists, nurses and allied health professionals through the Medical Outreach – Indigenous Chronic Disease Program to increase access to services for Aboriginal and Torres Strait islander people living in regional, rural and remote Australia.

Practices participating in the Practice Incentive Program Indigenous Health Incentive can also register eligible Aboriginal and Torres Strait Islander people for chronic disease management.

Medicare Benefits Schedule (MBS) statistics

The Medicare Benefits Schedule lists a range of medical services (consultations, procedures and tests) subsidised by the Australian Government, as well as the MBS rebate payable for each of these items.

The data presented in this tool about numbers of health checks are based on publicly available MBS reports from the Medicare Australia Statistics webpage (administered by the Department of Human Services). Those reports include numbers of MBS items billed to Medicare at the jurisdictional and Medicare Local levels. This health check tool uses those data to report numbers of 715 health checks at these 2 levels, as well as sums them to present numbers of checks at national and peer group levels. Since the Medicare Statistics webpage does not currently report MBS statistics at the Primary Health Network level, the AIHW developed a concordance (or correspondence) to derive Primary Health Network estimates based on Medicare Local numbers (see technical notes).

MBS statistics are subject to periodic review by the Department of Human Services. The Medicare Australia Statistics webpage notes that the reports and tables it provides are for general information purposes only. It also notes that while Medicare Australia takes care in the compilation and provision of the information and data, it does not assume or accept any liability for the accuracy, quality, suitability and currency of the information or data, or for any reliance on the information or data.

Medicare Locals

Medicare Locals were regional organisations which coordinated general practice and other health care services in the community for a geographic area. There were 61 Medicare Locals across Australia. Information about Medicare Locals can be found here and boundary and concordance files can be found here.

Medicare Locals were categorised by the National Health Performance Authority into 7 peer groups for easier comparison of similar Medicare Locals.

The Australian Government replaced Medicare Locals with Primary Health Networks in 2015. The new Primary Health Networks became operational from 1 July 2015, after a transition period from April 2015. The geographic relationship between these two structures is explained at relationship between Medicare Locals and Primary Health Networks.

Non-MBS 715 health care

The number of MBS 715 health checks billed to Medicare do not give a complete picture of all health checks provided to Indigenous people. Situations where care equivalent or similar to a MBS health check may be provided but not billed as a MBS 715 health check include:

  • where the care is provided by health care providers not eligible to bill Medicare (such as some health services provided by the Australian Royal Flying Doctor Service and by state and territory funded services)
  • where the care is provided by a MBS-billing service but for some reason is not billed—for example, if the patient does not have a valid Medicare number (as items cannot be billed without a Medicare number)
  • where the care is billed as another MBS item such as a standard consultation.

Health checks provided by services not eligible to bill Medicare are not included in the number of MBS 715 health checks reported on the Medicare Australia Statistics webpage, and therefore are not included in this tool.

Some areas, especially in remote areas, may only have small numbers of MBS-billing GP services. The number of items billed to Medicare, including 715 health checks, in those areas is therefore likely to be lower.

Number of services where GPs work

The tool shows the number of services where general practitioners (GPs) work, as access to health checks requires access to GPs. This information was based on two sources:

  • Details held by the Australasian Medical Publishing Company as at 2013. Services captured in those data include mainstream general practices, Aboriginal Community Controlled Health Services, and state and territory health clinics.
  • Data from the Australian Royal Flying Doctor Service, which supplied the AIHW with information about community clinics in remote and very remote Aboriginal communities as at 2013.

The tool displays the number of services where GPs work at the Medicare Local and Primary Health Network levels. Services are included regardless of whether they are eligible to bill Medicare, so not all services counted are able to provide MBS 715 health checks. Information on the number of GPs at each service is not available.

Information on the number of services where GPs work is also available from HealthDirect, an autonomous Government-funded public company. This map shows services where GPs work as well as Primary Health Network and Medicare Local boundaries. Because HealthDirect information is continually updated and may use different definitions for inclusion, the number of services shown in the HealthDirect map may be different from the number shown in the tool. Any comments or queries about services shown in the HealthDirect map can be emailed to: nhsd@healthdirect.org.au.

Peer groups

Medicare Locals vary considerably in terms of size, degree of remoteness and population characteristics; so comparisons between them are not straightforward. The National Health Performance Authority (NHPA) allocated each Medicare Local to one of seven peer groups to better enable comparisons of similar Medicare Locals. The peer groupings were based on socioeconomic status and remoteness, including the average distance to the closest large capital city and major hospital (see NHPA Technical Supplement).

Primary Health Networks

The Australian Government replaced the 61 Medicare Locals with 31 Primary Health Networks as of 1 July 2015, after a transition period from April 2015.

The geographic relationship between these two structures is detailed at relationship between Medicare Locals and Primary Health Networks. Information on the location of the Primary Health Networks, as well as boundary and concordance files, can be found here . Primary Health Network boundaries are aligned to Local Hospital Networks to facilitate working relationships with public and private hospitals.

The Australian Government has stated that Primary Health Networks will work with GPs, other primary care providers, secondary care providers and hospitals to ensure improved outcomes for patients.

Data at the Primary Health Network level are not currently available on the Medicare Australia Statistics webpage. To derive estimates of health checks at this level, the AIHW developed a concordance (or correspondence) between the Medicare Local level and the Primary Health Network level that is based on the relative distribution of the Indigenous population. See technical notes for more information.

Quarters

In this tool, quarters (Q) refer to the following periods: Q1—1 January to 31 March, Q2—1 April to 30 June, Q3—1 July to 30 September, and Q4—1 October to 31 December.

Relationship between Medicare Locals and Primary Health Networks

The Australian Government replaced Medicare Locals with Primary Health Networks in mid-2015. Most (50) of the 61 Medicare Locals are wholly contained within a single larger Primary Health Network, but 11 were split across more than one Primary Health Network.

Further information about the relationship between Medicare Locals and Primary Health Networks is available in:

  • a table (121KB XLS) which aligns Medicare Locals with the new Primary Health Networks
  • a map developed by HealthDirect which shows Medicare Locals overlaid by Primary Health Networks; the boundaries for Medicare Locals and Primary Health Networks can be seen simultaneously by hovering over different areas in the map.

Start dates for health check reporting periods

Data in this tool are shown from two different starting dates depending on the geographic level being considered:

  • at jurisdictional and national levels, the start date is the third quarter (July to September) in 2010 because this is the first full quarter for which data were available after the three separate age-based Indigenous health check MBS item numbers were combined to a single item number (715) (see timeline of major developments in health checks (161KB PDF)).
  • at peer group and Medicare Local levels, the start date is the third quarter in 2011 because this is the first full quarter after Medicare Locals were established. This start date is also used at the Primary Health Network level, as Medicare Local data have been corresponded to Primary Health Networks (see technical notes).

Timeline of major developments in health check implementation

The timeline shows major developments relating to MBS 715 health checks and the increase in the number of such checks over time. Developments included in the timeline are:

  • National Partnership Agreement: December 2008. The National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes included the Indigenous Chronic Disease Package. This package was funded by the Australian Government over 4 years from 2009-2013 and included a number of elements relevant to improving health check uptake. The majority of the activities of the former Indigenous Chronic Disease Package were consolidated into the Indigenous Australian’s Health Programme in July 2015.
  • Medicare Local Closing the Gap workforce: introduced in July 2009 as part of the former Indigenous Chronic Disease Package. This initiative provided Aboriginal and Torres Strait Islander Outreach workers and Indigenous Health Project Officers:
    • 86 full-time equivalent Indigenous outreach workers to support Aboriginal and Torres Strait Islander people access primary health-care services and follow-ups
    • 86 full-time equivalent Indigenous health project officers to lead Aboriginal and Torres Strait Islander health issues within Medicare Locals, and raise awareness of Closing the Gap initiatives relevant to mainstream primary care.
  • Practice Incentives Program Indigenous Health Incentive: March 2010. This Incentive, commenced under the former Indigenous Chronic Disease Package, is now included in in the Practice Incentives for General Practices Fund. It aims to support GPs to improve health care for Aboriginal and Torres Strait Islander patients, especially those with chronic disease.
  • Medicare Locals replaced by Primary Health Networks: July 2015. Funding for the Care Coordination and Supplementary Services and Improving Indigenous Access to Mainstream Primary Care programs was provided through Primary Health Networks in 2015-16. These programs were combined to become the Integrated Team Care (ITC) activity from 1 July 2016.

Usage rates

This tool shows usage rates of MBS item 715 health checks as follows:

  • quarterly usage rate: the number of checks in the quarter divided by the estimated quarterly population, expressed as a percentage
  • annual usage rate: the number of checks in the financial or calendar year divided by the estimated annual Indigenous population, expressed as a percentage.

Methods for deriving the quarterly and annual population estimates are detailed in the technical notes.

Acknowledgments

AIHW authors and contributors

This tool was originally designed and authored by Helen Kehoe, Ronda Ramsay and Helen Johnstone from the Indigenous and Children's Group at the Australian Institute of Health and Welfare. This team was responsible for the first (April 2014) and second (August 2014) releases, with assistance from Jeremy Spindler on the second release.

The third (December 2014) release was authored by Helen Kehoe, Jeremy Spindler and Michelle Gourley.

The fourth (July 2015) release was authored by Helen Kehoe, Jeremy Spindler and Adriana Vanden Heuvel. Valuable assistance was provided by Martin Edvardsson, Jessica Cargill and Brett Nebe.

The fifth (July 2016) release was authored by Helen Kehoe, Indrani Pieris-Caldwell and Stacey Costello. Martin Edvardsson, Ronda Ramsay, Jess Cargill, Bron Wyatt and Helen Johnstone also provided valuable help.

Fadwa Al-Yaman, Head of the Indigenous and Children’s Group at AIHW, provides ongoing advice and guidance on this project.

Stacey Costello, from AIHW’s Technology and Transformation Unit, built the original reports in the SAS VA software. He continues to help refine, improve and maintain the tool.

External contributors

Dr Mitchell Whitelaw, Associate Professor Faculty of Arts and Design at the University of Canberra, produced the first prototype of the tool and helped change thoughts into reality.

Prometheus Information Pty Ltd produced Indigenous population estimates at small geographic levels, under contract to the Department of Health. Population estimates at the Medicare Local, peer group and Primary Health Network levels used in the tool were based on, or sourced from, this work.

Thanks are also extended to the many stakeholders who provided input to the initial development of the tool, including:

  • Australian Medicare Locals Alliance and individual Medicare Locals
  • National Aboriginal Community Controlled Health Organisation and members
  • Royal Australian College of General Practice
  • the Australian Bureau of Statistics
  • the Australian Government Departments of Health, Human Services, and Prime Minister and Cabinet
  • advisory bodies including the National Advisory Group on Aboriginal and Torres Strait Islander Information and Data and the National Aboriginal and Torres Strait Islander Health Standing Committee
  • Inala Indigenous Health Service
  • Indigenous Eye Health Unit, Melbourne School of Population and Global Health, Centre for Health Equity, The University of Melbourne
  • National Centre for Immunisation Research and Surveillance.

Record of updates to the tool

Date Features
3 April 2014 Tool first released. Included Medicare Local information from 1 July 2011 to 30 June 2013.
Source of Medicare Local Indigenous population data was preliminary estimates developed by the Public Health Information Development Unit, University of Adelaide.
20 August 2014 Information at the national, jurisdiction and peer group level added.
Source of Medicare Local Indigenous population data changed to ABS 2011 estimated resident population (ERP).
Other Indigenous population data sources were 2011 ERP and projections to 2014.
MBS data from 1 July 2010 to 31 March 2014 (national and jurisdiction) accessed from Medicare Australia Statistics webpage on 4 June 2014.
MBS data from 1 July 2013 to 31 March 2014 (Medicare Locals and peer groups) accessed from Medicare Australia Statistics webpage on 6 June 2014.
3 December 2014 MBS data from 1 April 2014 to 30 June 2014 (national and jurisdiction) accessed from Medicare Australia Statistics webpage on 4 September 2014.
MBS data from 1 April 2014 to 30 June 2014 (Medical Locals and peer groups) accessed from Medicare Australia Statistics webpage on 12 September 2014.
28 July 2015 MBS data from 1 July 2014 to 31 December 2014 (Medical Locals, peer groups, jurisdiction and national reports) accessed from Medicare Australia Statistics webpage on 2 March 2014.
Primary Health Networks, numbers of services where GPs work and calendar year data added.
21 July 2016 Increased age disaggregation to 10 age groups for national and state and territory data.
Reported health check data for Australia and states and territories by calendar years, financial years and quarters up to 31 December 2015.

Suggested citation

Australian Institute of Health and Welfare 2016. Indigenous health check (MBS 715) data tool. Canberra: AIHW. Viewed [access date], <http://www.aihw.gov.au/indigenous-australians/indigenous-health-check-data-tool/>.