Government releases detailed breakdown of bulk-billing rates

Matt Woodley

18/12/2019 3:59:19 PM

Find out how your practice compares to the rest of your electorate.

Graphic representing Medicare data.
The Department of Health data also includes out-of-pocket costs.

The Department of Health (DoH) has released electoral statistics related to overall bulk-billing rates, percentage of patients with all attendances bulk billed, and average out-of-pocket costs since 2012–13.
The major release of detailed information was made in response to a question from NSW Labor Senator Deborah O’Neill, and also includes the same information for non-GP specialists.
Chifley, located in the western suburbs of Sydney, has the largest percentage of patients will all of their attendances bulk billed (96.1%), while Canberra has the lowest (32.9%).
According to the statistics, the national average percentage of patients with all attendances bulk billed has grown from 60.1% in 2012–13, to 65.27% in 2018–19. But this is still vastly lower than the 86.2% of total bulk-billed GP visits regularly touted by the government.
RACGP President Dr Harry Nespolon told newsGP the proportion of patients with all attendances bulk billed is a better indication of access to services than total bulk-billed visits, but that neither is an accurate gauge of the value of services that GPs provide.
‘The 32% increase in out-of-pocket fees over the past six years is a clear demonstration of the impact the Medicare freeze has had on both patients and GPs alike,’ he said.
‘Medical inflation has far and away outpaced the Consumer Price Index, and yet the Government still expects GPs to provide world-class primary healthcare on what are essentially 2014 rebates – which, by the way, were already too low.
‘The fact that GPs didn’t charge two in three patients at all last year shows what a heroic job primary care continues to do in the face of continually rising pressures.’
But, Dr Nespolon also cautioned that such a system is not sustainable and that practices should consider the RACGP’s position statement on billing for general practice services.
‘If the Government wants to continue to tout bulk-billing rates as a sign of how strong Australia’s healthcare system is, then they need to dramatically raise Medicare rebates as soon as possible,’ he said.
‘Otherwise, the RACGP believes practice owners should consider their bulk-billing arrangements and what is required in order to continue as a viable business that provides the top quality care Australians have come to expect.’
Solomon in the Northern Territory had the highest average out-of-pocket costs to see a GP in 2018–19 ($48.68), nearly double those recorded in Spence, South Australia ($24.87).
Tasmania was the only state that saw a reduction in the percentage of patients who had all their attendances bulk billed, whereas the proportion in Western Australia grew from 49.11% in 2012–13 to 64.29% in 2018–19.
Burt, in Perth’s south-eastern suburbs, recorded the greatest increase in patients who had all their attendances bulk billed, increasing from 52.8% to 80.7% over the past six years.
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Dr Kenneth Adams   19/12/2019 8:25:47 AM

The profession abdicated independent professionalism when it accepted the governments bulk billing program. One cannot serve two masters. It is folly to assume the government will ever have the same viewpoint as an independent medical practioner and keep remuneration up with inflation. I propose that the profession abandon bulk billing over a seven year period to allow patients and the profession to slowly adjust to a return to a doctor- patient relationship free of the myriad ways the government interferes.

In 2021 we should abandon bulk billing on Saturdays; Sunday in 2022; Monday in 2023; ... etcetera until our patients and the profession are once again independent. This slow roll over seven years will have gradual impact. We are already deciding who pays what. Taking the government out of the Equation will benefit the patients. Every doctor should offer his services commensurate with his or her independent judgement.

Dr Abdul Ahad Khan   19/12/2019 10:53:52 AM

I suggest the RACGP takes the Lead & arranges a Series of Strikes, in order to educate the Populace of INADEQUATE MEDICARE REBATES & win their support.

Suggested Steps :
1. Call a Nation-wide Rolling Strike, with GPs closing their Surgeries on a Monday in Jan.2020 from 8.00 am till 10.00 a.m..
2. Distribute Patient Education Pamphlets to all GP Surgeries - containing Medicare Rebates over last 15 yrs / The Cost of running a GP Surgery : Staff Salaries / Staff Super- Annuations / Third Party Insurance / Medical Indemnity Insurance / Continuing Medical Education Costs / Surgery Rent / Electricity costs / Annual Membership Fees with AMA / RACGP / ACRRM / Surgery Equipment & Consumables Costs, etc, etc.

Except for Pensioners & under 16s, start charging from say $ 5/- a Visit & keep increasing till Sustainability is achieved.

Repeat the Strike every Month, till the Govt. caves in..

Win the Populace over & see which Govt. dares displease the Populace.


Dr Mark Andrews   19/12/2019 12:23:00 PM

The above are both fantastic ideas.
Why is the RACGP not advocating for this in their advertising to the public??

Dr James Roger Ewing Moxham   19/12/2019 1:48:01 PM

Earlier this year our practice abandoned universal bulk billing. We are now privately billing about half the consults, and on weekends, every single consult is privately billed, with the full fee paid up front. Interestingly from the statistics, our clinic happens to be in the lowest bulk billing area in the state, and our bulk billing rate is very similar to the average in that electorate, so it looks like many other GPs have made a similar decision.
The freeze was one factor. The other factor was Medicare targeting statistical outliers, and it seems they have moved on from the 80:20 rule and have largely finished targeting home visits, and are now targeting Bulk Billing. Specifically, there is now an absolute upper dollar limit that can be claimed from Medicare. It is whatever the 99th centile happens to be. It looks like Medicare is being shut down and the only way to survive in this new world is to abandon bulk billing.

Dr Marc Houghton Heyning   19/12/2019 6:06:13 PM

Thank you for the Electorate breakdown to allow comparison. I am in Richmond electorate with average BB rate of 85% and our clinic's rate is 33%. We hardened our stance on what consults are BB'ed several years ago - lost a few patients but gained the ones who appreciate 'value-added' services. Am I any richer? No, but I am less stressed.

Dr Abdul Ahad Khan   19/12/2019 9:48:05 PM

Dr. Moxham, you have taken the RIGHT STEP.
The RACGP can surely assist all of us Grassroot GPs, by taking on the Govt., with the Support of the Populace on our side. I have outlined above, as to what the RACGP should be doing.