Eating Disorder MBS item evaluation

The Eating Disorder MBS items initiative is a key part of Australia’s stepped care system, designed to improve access to evidence-based treatment for people with eating disorders. Below is an overview of recent evaluation findings and recommendations for enhancing this program.

Overview of Eating Disorder MBS Items

Introduced in 2019, the Eating Disorder Plan (EDP) provides Medicare-subsidized services to people with severe eating disorders. The EDP includes an initial assessment, a treatment plan, access to up to 40 psychological sessions, and up to 20 dietetic sessions, with periodic reviews by general practitioners and specialists. This support enables a more comprehensive, person-centered approach to treatment.

Key Evaluation Findings

An evaluation assessed whether the MBS items meet the needs of people with eating disorders, their caregivers, and healthcare providers. The findings reveal strong support among patients, carers, and health professionals for the EDP’s role in enhancing access to structured care. Positive outcomes included improved symptom management, increased access to multidisciplinary care, and higher satisfaction rates among users.

However, barriers remain, including:

• Low Awareness: Many potential users and providers are unaware of the EDP.
• Limited Accessibility: Regional and remote areas, as well as lower-income populations, face difficulties accessing services.
• Specialist Availability: Lack of available professionals with eating disorder expertise.
• Eligibility Challenges: GPs report challenges in assessing eligibility for non-underweight eating disorder presentations.

Recommendations

To address these issues, the evaluation recommends:

1. Raising Awareness: Provide clear information about the EDP to patients, families, and health professionals.
2. Improving Access: Streamline eligibility criteria, remove unnecessary specialist review requirements, and support bulk billing in underserved areas.
3. Supporting Families and Carers: Offer targeted psychological services for families, enhancing their role in treatment.
4. Workforce Training: Upskill GPs and mental health providers to improve diagnostic and treatment competencies.
5. Building the Workforce: Introduce incentives for clinicians to pursue specialized training and supervision.
6. Coordinated Care: Expand case conferencing to include mental health professionals and dietitians.

Immediate actions can strengthen the EDP, while other recommendations will require further development to ensure the initiative’s sustainability and effectiveness.

Support for GPs

There are several free resources available that can help a GP to understand and use the EDP and provide care coordination across the multidisciplinary team. 

• NEDC’s Eating Disorder Core Skills: eLearning for GPs: free, comprehensive, foundational training which will equip GPs with the knowledge and skill to understand, identify and assess eating disorders, provide medical treatment, lead the multidisciplinary team, manage MBS items, and provide ongoing recovery support.
• InsideOut GP Hub: for use at the point of care and includes a suite of digital tools and information designed to save time, enhance workflow and support diagnosis, assessment and treatment. 
• NEDC’s MBS Item Quick Reference Guide
• Eating Disorder Examination Questionnaire (EDE-Q) online format
• EDP template: printable and fillable PDF templates available
• Referral pathway: ANZAED Credentialed Eating Disorder Clinician database
• Referral pathway: Butterfly referral database

Support for people experiencing an eating disorder and families/supports

• Information about EDPs, including a handy factsheet outlining the steps to access an EDP
• Support navigating treatment: Butterfly National Helpline and Eating Disorders Victoria Hub
• NEDC’s EDP Session Planner template

Support for mental health professionals and dietitians providing treatment

• Eating Disorder Examination Questionnaire (EDE-Q) online format
• NEDC’s EDP Session Planner template
• Supervision: search ANZAED’s member database under ‘supervision offered’
• Training and professional development opportunities: NEDC’s Upcoming Training and Events, Digital Resources database, and national training and professional development database.

We have collated these resources on our Eating Disorder Treatment and Management