Time and financial outcomes of private practice dietitians providing care under the Australian Medicare program: A longitudinal, exploratory study

Abstract

Aim: To better understand the income of dietitians delivering Medicare Chronic Disease Management services by comparing the amount of time dietitians spend on activities with remuneration received. Methods: Data were collected on time invested and remuneration received for 179 consultations provided by 20 dietitians through the Medicare Chronic Disease Management initiative. Descriptive statistics and t-tests were used to compare time spent and remuneration received. A mixed effects model was performed to assess the significant factors in predicting the mean hourly rate received for consultations. Results: Consultations accrued an average of $67.32 ± $24.38 (range $0–$150) in remuneration, and required an average of 44 ± 20 minutes (range 14–136 minutes) including over 10 minutes of administration time. The average calculated gross rate of pay was $102.62/hour. Set-fee consultations were longer than bulk-billed consultations (51 minutes vs 39 minutes, P = 0.002), but resulted in greater remuneration ($83.20 vs $52.95, P < 0.001). Initial consultations resulted in greater remuneration than review consultations ($76.52 vs $60.75, P < 0.001). Dietitians without administration assistance spent more total time on consultations compared with dietitians with administration support (54 minutes vs 42 minutes, P = 0.001), but there was no difference in fees charged (P > 0.005). Conclusions: The hourly income received by dietitians providing services under Medicare appears high; however, practice expenditures have not been considered in the present study. Dietitians should consider the logistical and financial outcomes of their practices in order to enhance financial sustainability.