Do bulk billing changes mean cheaper GP visits?

The Federal Government hopes its Medicare boost to GPs will make it easier for consumers to find a bulk billed GP appointment, with all Australians now eligible for bulk billing GP services.

Under the new funding arrangement, those medical practices that opt in will receive an additional 12.5% on the Medicare Benefits Schedule.

The extra funding is designed to encourage more bulk billing – but bear in mind, it's still up to the individual doctor and medical practice to opt in, and not all services will be bulk billed.

The benefits to consumers are potentially no or lower consultation fees and out-of-pocket gap fees. It’s early days and how effective the government’s funding ‘carrot’ to GPs has yet to be seen.

National Seniors Australia (NSA) says Australia’s health system needs more than a lift in Medicare rebates; major reform is needed. More on that later.

Doctors respond to bulk billing

The Australian Medical Association has welcomed the funding lift and is encouraging the government to further increase Medicare rebates for longer consultations.

It says this is needed to more realistically reflect Australia now has a much higher burden of complex needs and chronic disease than when Medicare was established.

The AMA cautioned that practices are assessing the impact of the new bulk billing arrangements and “given the significant increases in the costs of running a general practice, not all will be in a position to extend bulk billing to more patients, which the government has already acknowledged”.

According to the Royal Australian College of General Practitioners (RACGP), the changes have so far convinced just 13% of metropolitan practices to change to fully bulk billing.

It says government data show just 622 of Australia’s 4,720 metropolitan practices plan to change from mixed-billing to bulk-billing in the wake of the changes.

This is in addition to the 935 practices which are already fully bulk-billing clinics.

The data, gathered from an expressions of interest process, shows 209 of Australia’s 620 regional practices have indicated they will become bulk-billing practices, with 108 clinics intending to change their current approach.

Seventy-three clinics in large rural towns plan to switch, with the strongest growth expected in small rural towns, where more than 60% of the 243 interested clinics do not currently bulk bill all patients.

The RACGP is also pushing back against government public relations spin that the changes mean greater earnings for general practices that bulk bill.

RACGP president, Dr Michael Wright, described the figures used as a “misrepresentation” that does not account for the full complexity and costs of providing care.

“We’ve been in touch with the highest levels of government to push back against this unhelpful public positioning because it does nothing to restore the trust that GPs will need to participate in this program,” he said.

It also does not consider the non-patient facing time that GPs undertake to ensure safe care, including checking results, other non-remunerated administrative tasks, and ongoing education."

The RACGP is urging the government and patients to respect individual decisions made by GPs and practice owners “who must make professional decisions in the best interests of their practice and patients”.

Dr Wright said, “While there are many clinics that will benefit from taking up all these incentives, we also know that thousands of practices will not.”