Structural change in Medicare funding: Impact on the dietetics workforce

Aim:  To review the dietetic workforce profile and share of Enhanced Primary Care claims in the context of the Strengthening Medicare support for allied health services.
Methods:  Dietitians Association of Australia membership data from 2004 to 2007 were analysed to assess changes in the number and work hours of private practice dietitians. Medicare data for 2004–2005 to 2006–2007 were reviewed regarding uptake and distribution of allied health consultations.
Results:  The number of allied health Enhanced Primary Care consultations doubled between 2004–2005 and 2005–2006, with similar increases in 2006–2007. Physiotherapists claimed most, followed by podiatrists, then dietitians. Dietitians claimed most consultations per provider in 2004–2005 and 2005–2006, surpassed by podiatrists and diabetes educators in 2006–2007. The number and full-time equivalents of private practice dietitians increased since 2004. Almost one-third of members were engaged in private practice work by 2007. Approximately half of these worked eight hours or fewer per week in this setting over the period surveyed (45.9–50.8%).
Conclusions:  Medicare funding for allied health has provided structural change and presents an opportunity for growth in the private sector of dietetics. While the number and full-time equivalents of private practice dietitians increased since 2004, the anticipated sharp increase relative to other work areas was not seen. Dietetics had a high uptake of Medicare consultations per provider and consultations increased each year; however, the declining share of total consultations demonstrates that dietitians are not using the opportunity presented by Medicare to the same degree as some allied health professions.