Key pledges for May’s federal election include: A$8.5 billion pledged to increase incentives Enables GPs to bulk bill patients. The government moved quickly after the election and planned to start new measures from 1 November.
Patients will not have to pay out-of-pocket to see their GP if they receive a bulk bill. If patients are not bulk billed, GPs may charge out-of-pocket costs. The new incentive scheme provides GPs with a small additional payment to cover the difference.
It is unlikely that 100% of your GP visits will be bulk billed due to bulk billing incentives. But that was not the government’s ambition. target The goal is to increase bulk billing to 90% by 2030. current exchange rate It is 79%.
Here’s what’s changing and what it means for patients and GPs.
Read more: The major political parties want bulk billing for nine in 10 GP visits by 2030. Here’s why you shouldn’t aim for 100%:
Barring a few mistakes, bulk billing has declined.
Medicare promises that financial barriers to health care will become a thing of the past. What you need is a “Medicare card, not a credit card.” That was Prime Minister Albanese’s mantra during the election campaign, when he waved his Medicare card at every opportunity.
This has been a consistent Labor slogan since then-Prime Minister Bob Hawke and Health Secretary Neal Blewett introduced Medicare 40 years ago.
But the Abbott-Turnbull-Morrison government froze Medicare rebates for nearly a decade. This means GP net profits have fallen inversely as inflation rises and the costs of running clinics increase. Many medical institutions have abandoned bulk billing and introduced patient copayments.
Bulk billing rates were artificially inflated in the first year of the pandemic because new telehealth items were only paid for when bulk billed. However, as normal billing practices resumed, mass billing began. free fall.
When Labor is elected in May 2022, Bulk billing rate is 87% However, it fell by 10 percentage points in one year.
Labor has implemented what was hoped to be a quick fix based on the bulk billing incentives it introduced. federation. The Department of Labor has tripled incentives for visits by concession card holders and bulk-paying children.
That stopped the decline. However, it has not brought bulk billing rates to pre-pandemic levels.
How much is the rebate?
Bulk billing incentives will apply to all Australians from 1 November.
Additionally, if your practice bulk bills for all patient visits, you will receive an additional 12.5%.
Rebates for a typical (Level B, 6-19 minutes) consultation are as follows: ₩43,900. Bulk billing incentives include: $21.85 A total of $65.75 if eligible patients are billed in bulk in a metropolitan area (or $73.97 if all practices are billed in bulk for all patient visits).
Larger bulk billing incentives will be available next. Regional, rural and remote region.
The average out-of-pocket cost for a quarter of a non-bulk billed visit is approximately: $50 – Significantly less than bulk billing incentive payments.
GPs and practice owners are now crunching the totals to see if they need to increase bulk billing. The government calculator Help them do this analysis.
Will my GP be bulk billed? It will depend on these things
Six factors will determine whether your practice will transition to full bulk billing.
1. Ideology
Some GPs and practice owners are adamantly opposed to bulk billing. Some people believe that patients will not value services if they do not pay for them. Others believe bulk billing makes us too dependent on the government.
2. Indexing risk
GPs may not trust the government to continue indexing rebates each year for inflation. GPs were hurt by the previous government’s freeze and do not want to risk having to reintroduce patient charges if a future government freezes rebates again.
To overcome these concerns, recently GP incentive payment review We recommend that an independent body establish new rebate levels each year.
3. Current out-of-pocket expenses
The current practice of charging very high out-of-pocket costs will not change. Many of these are in wealthy areas.
Expanding eligibility for bulk billing incentives and an additional 12.5% boost to 100% bulk billing alone may not be enough to offset the loss of revenue for these clinics.
4. Current lump sum billing fee
If your current bulk billing rate is low, even if you have modest deductibles, switching to full bulk billing may result in reduced revenue.
5. Offsetting consumer pressure
The government is launching a promotional campaign to encourage bulk billing to general medical centers. If clinics decide to charge a bulk fee to all their patients, the government will encourage them to advertise this by putting up posters outside their clinics.
This may lead patients to switch doctors or ask their GP or clinic receptionist why they are not receiving bulk bills. Consumer pressure could make life uncomfortable for GPs who continue to charge out-of-pocket costs, especially in low-income areas.
6. Availability of alternatives
The expansion of alternatives to general care, such as prescriptions from pharmacists, may lead to a shift away from practices that still charge out-of-pocket costs.
Read more: Pharmacists should be able to work with GPs to prescribe medicines for long-term conditions.
Are the government’s goals achievable?
Contrary to the view of some GPsThe government’s target of 90% of all attendance billed in bulk by 2030 will probably be achieved.
There will be an immediate uptick. current exchange rate When the new contract begins November 1, it is 79%. Currently the lowest regional bulk billing rates are: Socioeconomic status is already 89% And it’s likely to get close to 100% pretty quickly.
The combination of patient pressure, the perception that the sky is the limit for the new regime and the perception that the current government can trust the rebate index means that bulk claims rates will continue to rise in the coming years.
This means lower financial barriers for patients to access essential primary care.
