News

---

Medical Costs overhaul creates ‘substantial uncertainty’ for GPs

---

The RACGP has raised concerns about the potential of individual GP fee and billing data being publicly published by default, saying the current plan risks undermining the financial sustainability of general practice.
 
In its submission to a Federal Government plan to overhaul the Medical Costs Finder website, the college says that while it supports transparency, it cannot support the legislation ‘without appropriate safeguards and consultation with the profession’.
 
The proposed new laws would enable the publication of information on medical fees charged by medical practitioners and likely out-of-pocket costs as part of a crackdown on non-GP specialist fees.
 
It could also enable the publication of GP fee and billing data from administrative datasets, but without the context of clinical factors such as consultation length, case complexity, preventive care, patient demographics, or multimorbidity.
 
The absence of such information, the college argues, runs the risks of the legislation creating ‘misleading comparisons, influencing billing behaviour in unintended ways and placing additional pressure on the financial sustainability of general practice’.
 
The RACGP suggests the limited uptake by non-GP specialists on the Medical Costs Finder, introduced in 2019 to improve fee transparency among non-GP specialists, ‘appears to be one of the factors’ behind the proposed legislation.
 
‘The current proposal signals a shift from voluntary participation toward default publication of practitioner-level information derived from administrative datasets,’ the college writes.
 
‘General practice is structurally different from non-GP specialist private practice. Fee data derived from administrative datasets does not capture the complexity, consultation length, continuity of care, or the broader role of general practice within the health system.’
 
The RACGP is also concerned by potential issues identified in the legislation’s Impact Analysis, which identified ‘a number of areas where the available evidence regarding the effects of practitioner-level fee transparency is limited or uncertain’.
 
These include the potential effect on consumer choice, broader impacts on service access in different geographic and socio-economic contexts, and the potential for fees to converge toward market averages.
 
This, argues the college, poses risks to the viability of small community-based practices, longer and more complex consultations, and access to care for disadvantaged communities.  


‘The Impact Analysis … highlights substantial uncertainty and concern regarding the behavioural and system impacts of publishing practitioner-level fee data,’ it wrote.
 
‘Given the evidence gaps, careful consideration must be given before extending the proposed transparency framework to general practice.’
 
Among the RACGP’s recommended amendments are:

• the inclusion of ‘clinical and service context’ data such as consultation length, complexity and continuity of care in any fee publication data
• the inclusion of patient demographics, geography and policy setting limiting the publication of bulk-billing rates
• deferral or limiting of the publication of GP fees until gaps in the Impact Analysis are addressed and ‘appropriate safeguards, evaluation and consultation processes are in place’.

The Department of Health, Disability and Ageing says there are no immediate plans to include individual GP fees in any upgrades to the Medical Costs Finder website, despite references to general practice in new legislation.
 
The final report on the legislation is due on 15 April.
 
Log in below to join the conversation.

---

Medical Costs Finder

---