In Australia, there has been growing concern that sub-optimal collaboration between different providers may impede the quality and outcomes of care, both in the physical and mental health arenas. In order to facilitate greater collaboration between providers, a series of new item numbers was added to the Medicare Benefits Schedule (MBS) on 1 November 2000, which provided remuneration for case conferences between physicians and other multidisciplinary providers. These item numbers were introduced in recognition of the fact that improved co-ordination in community settings has the potential to lead to improvements in consumer impacts/outcomes through a more flexible, efficient and responsive match between consumers' needs and services [1
]. The item numbers enabled physicians to take part in discharge or community case conferences of varying lengths with other providers. As a sub-group of physicians, psychiatrists were eligible to use these item numbers to improve their collaboration with other mental health care providers, including staff of state/territory funded inpatient and community mental health services, other private mental health care specialists like psychologists, and GPs and other primary care practitioners.
The original item numbers distinguished between organising and co-ordinating a case conference (where three other providers had to be present), and participating in one (where two other providers had to be). The nature of mental health care meant that the more stringent attendance requirements associated with organising and co-ordinating a case conference could not always be met, so, on 1 November 2002, an additional set of item numbers was added, designed especially for use by psychiatrists. These new item numbers relaxed the attendance requirement for organising and co-ordinating a case conference, reducing the mandatory number of other providers to two. Table provides a breakdown of the item numbers, detailing the rebate associated with the different combinations of psychiatrists' roles, number of other attendees, consumers' settings, and case conference duration.
Summary of criteria for individual case conferencing item numbers
The current paper reports on an evaluation of the introduction of these item numbers which aimed to: (a) examine the processes/operation of the case conferencing item numbers, from the perspective of psychiatrists and consumers; and (b) consider the costs associated with the case conferencing item numbers, and their impacts/outcomes for consumers.