Funding uncertainty threatens essential cardiac services: Is 1 July deadline achievable?

MedTech & Diagnostics News: As the clock ticks toward July 1st, a shadow of uncertainty hangs over the future of cardiac technical support services for cardiac implantable electronic devices (CIEDs). Stakeholders are in a state of unease as the government is yet to release recommendations from the Medical Services Advisory Committee (MSAC) or outline the next steps for funding implementation.

Tanya Hall, CEO of hearts4heart, voiced her concerns regarding the ongoing ambiguity.

“We are concerned that we are yet to receive recommendations from the Department of Health regarding changes to cardiac services,” Ms Hall told Health Industry Hub. “We hope that patients are at the forefront of any changes affecting these services. If the current funding arrangements are removed or reduced, there is a risk that patients will face numerous unintended consequences.”

While CIEDs had their benefits reduced by 40% on 1 July 2023 as part of the Prescribed List (PL) reforms, the reductions applied only to the proportion of the benefit that corresponds to the value of the medical device and not the technical support services provided by industry-employed allied professionals (IEAPs).

Ian Burgess, CEO of the Medical Technology Association of Australia (MTAA), representing medtech companies such as Medtronic, Abbott, Boston Scientific, Biotronik, and MicroPort CRM, argued that “the continuation of funding for cardiac technical support services is vital for the many Australians who rely on it to keep their devices functioning effectively throughout their life.”

“While each company will make its own assessment, cuts in funding for these services will inevitably impact the cardiac industry’s ability to deliver this essential service to patients. Any reduction in industry support services for CIEDS will have a real impact on patients – more out-of-pocket costs, more travel to access these services, or longer waiting times as patients may return to the public system,” Mr Burgess told Health Industry Hub.

Hon Yuen, Senior Business Director of Cardiac Rhythm Management at Medtronic, said “The cardiac services provided by Medtronic are essential to patient care, ensuring equity and continuity of care for patients living in metro, rural and regional communities.

“We acknowledge the funding of cardiac services is complex and takes time to ensure there are no unintended consequences. Patients must remain at the heart of any government reforms especially as we approach the decisions scheduled to commence from 1 July.”

The Professional Cardiac Scientists Association (PiCSA) has issued a plea, urging the government to prioritise patient welfare and devise a funding model that safeguards both industry and non-industry workforce roles.

“Funding reform measures are necessary, but must not undermine the viability of third-party non-industry providers or bias against the direct employment of cardiac physiologists,” the organisation said.

Furthermore, PiCSA proposed that employers and the Australian government enforce registration with the Australian Accredited Clinical Physiologists (ACCP) for the cardiac device workforce. This measure, they argued, would uphold stringent quality, safety, and ethical standards in the delivery of cardiac technical support services.

Dr Michael McGee, Consultant Cardiologist from regional New South Wales, underscored the potential ramifications of funding uncertainty in a recent interview with Health Industry Hub.

“Some of the most vulnerable patients, who don’t have the means to travel [to metro areas] to have these devices checked will be disproportionately impacted,” Dr McGee cautioned. “These devices are incredibly complex and technical. While you can train someone generically to manage them all on a basic level, you’re going to lose a lot of nuance and benefits. As we have certainly seen in the heart failure space, that lack of optimisation of these devices does increase mortality. So, if the government is going to pay for these devices, it makes sense to optimise them to make sure that we’ve not wasting that investment and patients are getting everything they can from it.”

Adding to the chorus, the Cardiac Society of Australia and New Zealand (CSANZ) Position Statement on CIEDs noted, “Industry holds an important role in facilitating the optimal device programming for each patient and in trouble shooting device-related issues. Industry provide and maintain the device programmers that are a prerequisite for CIED follow-up. Industry is also integrally involved in the provision of remote monitoring services.”

As industry stakeholders prepare for a briefing with the Department of Health on Thursday, the fate of cardiac technical support services hangs precariously in the balance.

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