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How should the 100% bulk-billing incentive loading be allocated?


Anastasia Tsirtsakis


17/07/2025 4:17:13 PM

With significant changes just months away, 71.6% of survey respondents said 100% of the loading should go to the GP, with individual arrangements for how the practice component is to be paid.

GP speaking to patient.
GPs at participating practices must bulk bill all eligible services for all patients to be eligible for the new 12.5% incentive loading.

GPs have made their views loud and clear when it comes to the allocation of a soon-to-be introduced bulk-billing incentive.
 
As part of the Federal Government’s efforts to incentivise bulk billing, from 1 November, the tripled bulk-billing incentive will be expanded to all Medicare-eligible people, with practices that bulk bill every patient eligible to receive an extra 12.5% loading payment on Medicare rebates.
 
In March, the Department of Health, Disability and Ageing (DoHDA) said the incentive payment will be split between practices and GPs, and that this split ‘will be determined in consultation with the sector prior to the program’s launch’.
 
Ahead of the incoming changes, a recent newsGP poll asked GPs exactly how they would like the 12.5% bulk-billing incentive loading to be allocated.

Of the 1399 poll respondents, an overwhelming 71.6% of GPs said they believe 100% of the loading should be paid to the GP, with individual arrangements then determining how the practice component is to be paid.
 
Just 9.7% want the incentive payment to be split 50:50 between the GP and the practice, 10.8% said 100% of the payment should go to the practice, with the service entity distributing as agreed to the GP, while 7.9% said they were unsure.
 
RACGP President Dr Michael Wright told newsGP the poll’s results are in line with what he has been hearing on the ground, and highlight the importance of exploring how practices who take up the incentive will make it work best for them, their practice and their patients.
 
‘This is what I’ve been hearing – most GPs have said that this additional funding should just be paid the same way as other Medicare billings. That looks like the simplest way,’ Dr Wright said.
 
‘These poll results present a really useful range of views, and we look forward to working with the Health Department on this program.
 
‘The RACGP represents GPs working right across the country, including rural members and practice owners, so we are best placed to provide balanced insights into the design of this program.
 
‘The RACGP is the logical place for the Department to talk to in best designing this program to succeed.’
 
Associate Professor Rashmi Sharma, Chair of the RACGP Expert Committee – Funding and Health System Reform, said the poll results show the diversity of Australia’s GPs.
 
‘It’s something that needs clarity, and that clarity needs to be provided quickly,’ she told newsGP.
 
‘These are business decisions that directly affect the viability of practices in terms of the services that we can offer, the cost that we can absorb, and the payments to people that work within practice – it’s very, very complex.
 
‘Because of the complexity of this landscape, it’s really important that the Government sits down with the RACGP and actually works this out.’
 
Echoing Dr Wright’s calls, Associate Professor Sharma said any changes must be made in collaboration with the RACGP and its members.
 
‘It won’t be successful without the buy-in and trust from GPs and from practice owners, so there’s certainly got to be the detail worked out with the profession in terms of how it could actually work,’ she said.
 
‘My message to the Government is to talk to us, don’t just do it and then find out that people are just going to say, “well, that’s not actually how the real world works”.
 
‘At the end of the day, they have to also understand that this may require changes to contracts and those things take time – you need adequate time rather than just sorting it out the week before.’
 
newsGP contacted the DoHDA for comment.
 
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Dr Steve Hambleton   18/07/2025 8:58:29 AM

It seems to me that if most of us work in serviced office arrangements then the answer is simple. Each practitioner operates an individual practice. That practice has "arrangements" with their service provider which will apply to payments to that practice, simple. Another reason that State Government Payroll Tax "rules/tax grab" complicate sensible business structures. State Governments would do well to consider the health outcomes of the population not how to clip the ticket on the way through.


New registrar   18/07/2025 9:27:32 AM

So that’s it is it? Dr Wright and the college are just going to give up and accept everything? What happens when the incentive doesn’t change for the next however many years because there’s no pressure on the government to do so (with ongoing minimal changes to the rebate)? A pay cut every year from now until forever. Practices and GPs accepting this are accepting the government having unilateral control over their wages and growth. And now, the bonus for this pay cut shouldn’t even go to the very people who are taking it. As a new registrar, it’s really quite concerning that no one seems to care about the future of general practice in the very organisation that’s supposed to represent it. I think the future of GP is looking rather bleak. Maybe it’s time to consider another specialty.


Dr Matthew Piche   18/07/2025 11:38:02 AM

Allocating the money to the practice makes sense if they are trying to force bulk billing on practitioners through clinics that would enforce 100 percent bulk billing. I would think that larger corporates would be able to enforce this through their own policies.

So, in this way the incentive becomes subjugative.

It benefits the bottom line of practices that already operate like mills, which is not how you'd want to be treated as a patient or as a doctor. The reception should be no surprise.


Dr Peter James Strickland   18/07/2025 4:31:15 PM

ALL the incentive should be paid to the doctor ---the DoHDA is playing 'funny buggers' here --it everything to do with control of GPs by the bureaucrats --ALL payments must be made immediately to the doctor doing service, and on the date of the service. You are NOT servants of the government, so do not let the dollars get in the road of the principle of independence of you as a GP, or you will be trapped in the already over-bureaucratic approach to general practice already developed by these bureaucrats. Medicare rebates are the 'insurance' promised by govt. to patients --your total fees should be different for each GP service as you please, and require to survive long-term.


Dr S   18/07/2025 6:14:34 PM

In response to The new registrar- you are 100 percent correct on all the points!


Dr Paul Raymond Mara, AM   19/07/2025 4:03:22 PM

With due respect to Dr Steve Hambleton, the current pseudo independent contractor engagement model with ever increasing demands on billing percentages for income is the primary reason why general practice is being consigned to the dustbin. Junior doctors don't want to churn and burn, practices cannot compete and do not have the resources to build quality systems and modern health care needs are not being met - UCCs, pharmacists, anyone.
What is the difference between an independent contractor and a salaried GP - a lifetime cost in excess of $500,000 in fees paid to accountants, lawyers and other so called financial advisors. Is payroll tax a dud, yes but for everyone not just doctors. Do GPs get paid enough through rebates in providing quality care. No. Is there are decent return for hardworking practice doctor owners. No.
If practices were truly service entities alone then why don't they charge doctors a rent or service fee that is based on cost plus.