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Quarter of GP clinics ‘unlikely to join’ new bulk-billing program: DoHDA


Morgan Liotta


22/07/2025 4:57:49 PM

The Federal Government has been told an estimated 23% of practices are unlikely to take part in the Bulk Billing Practice Incentive Program.

Patient waiting to pay at GP clinic reception
The Government’s upcoming incentives program aims to lift bulk-billing rates to 90%.

Almost one quarter of general practice clinics are unlikely to take part in the Bulk Billing Practice Incentive Program set to kick in 1 November, according to advice given to the Federal Health Minister by his own department.
 
Under the Federal Government’s landmark healthcare reforms, the key initiative will see the tripled bulk-billing incentive 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.
 
But in newly released advice to Health and Ageing Minister Mark Butler from the Department of Health, Disability and Ageing (DoHDA), the Secretary estimates 23% of clinics are unlikely to join the bulk-billing program ‘based on financial incentives’.
 
However, the program ‘may increase competition in the market and consumer demand for bulk billing, which may lead to higher uptake amongst these clinics,’ the brief states.
 
‘There is a risk that the percentage of the 12.5% incentive split between practices and providers is not considered a sufficient incentive for practices or providers to join the program.’

According to figures in the DoHDA brief, GP out-of-pocket costs increased from $41.12 per service in 2020–21 to $44.89 in 2023–24, with general practice clinics bulk billing all services halved over the past three years to 26%.
 
Under the Government’s 1 November incentive, it promises nine in 10 GP services will be fully bulk billed as part of an $8.5 billion package to be delivered over four years.
 
But the controversial announcement raised concerns among GPs of how realistic this model of billing would be to keep their practices financially viable, with various polls indicating GPs are not committed to move to a 100% bulk-billing model – as reflected in the briefing to the Minister.
 
Results from a recent newsGP poll of 1399 respondents reveals 71.6% of GPs believe 100% of the 12.5% bulk-billing incentive loading should be allocated to the GP, with individual arrangements then determining how the practice component is to be paid.
 
RACGP President Dr Michael Wright told newsGP the college is committed to working with the Federal Government to ensure the program is ‘designed to succeed’.
 
‘The Federal Government is making a significant investment in Medicare which is much needed, particularly after the decade-long Medicare freeze and chronic underfunding of Medicare before that,’ he said.
 
‘At the end of the day, we share the Government’s commitment to ensuring all Australians can access affordable general practice care.’
 
The DoHDA brief also indicates that some clinics have offered to establish new fully bulk-billing clinics operating in locations described as ‘bulk-billing deserts’ such as the Australian Capital Territory, where funding was allocated to save a bulk-billing health co-operative clinic in Tuggeranong.
 
It states that legislative changes are needed to update the patient eligibility for the bulk-billing incentives, with the DoHDA provide Minister Butler with the draft requirements to enable implementation from 1 November.
 
newsGP contacted the DoHDA for comment.
 
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Dr Dave   23/07/2025 9:47:33 AM

"To become Australian PM all you need is a Mediscare card not a credit card"


Sam O   23/07/2025 11:36:49 AM

23%?
Does this refer to the number of clinics who will not universal bulk bill post November 1?
i.e. 77% of clinics are going to be universal bulk billing?
Where has this number come from?

Seems to be WAY off and either:
-Wrong
-Deliberately misleading in order to pressure others into feeling that they are the minority for not going to UBB?

And potentially explains the Govt logic and policy position. If they have advice that 77% or so would take it up, then it would seem to be a sensible policy?
When in reality it's going to be probably 77% of mainstream GPs NOT taking it up, not the other way round!


Dr Rolf Tsz Kit Tsui   23/07/2025 12:12:48 PM

The current tide towards independent billing is unstoppable. The freedom to enact your own value, when and how much are more rewarding than being tied to endless rules and regulations with bulk billing and other government incentives which flips and flops every election cycle. You can't run a business like that. Time to get off the government's gravy train and learn to say "no" RACGP to these financial crumbs of despair!


Dr Mina Rezkalla   23/07/2025 12:31:56 PM

Why are practices even considering this rubbish? It’s embarrassing to be part of a college that’s actually advocating for its members to sell their souls to the government instead of charge their worth. While the pharmacy guild continues to lobby for scope creep into our line of work, the RACGP is focused on making sure we aren’t paid privately or respected as the specialists we do claim to be. I’ve never heard of a bulk billing cardiologist, or private surgeon, or geriatrician or paediatrician. Just like any other speciality, we should be paid a private fee-for-service, not working as some pseudo-government employees yet somehow private practitioners. Medicare is an insurance company for the patient, it is not there to fund our entire income. Have some self-respect and charge properly for your time - anything that’s “free” is generally considered worthless


Rural GP   23/07/2025 5:32:49 PM

Are DoHDA then saying that more than 50% of practices are about to change to fully Bulk billing ? I may be out of touch, but that seems optimistic.


Dr Nic   23/07/2025 7:28:48 PM

Where did they get 23% from? That figure is misaligned with the general consensus around the incentive - I can't imagine it is accurate at all. There doesn't even seem to be any effort made in this college-published piece to counter this clearly misinformed 23% figure with member perspectives. It's practically publishing DoHDA propaganda.


Dr RM   24/07/2025 6:20:09 PM

Dr Mina Rezkalla - You are totally correct
I can’t believe our college is selling us out this way with weak representation
Pharmacy guild and ANU are so much stronger than our college
I really don’t know how the college can justify the fees

I say to all GP colleagues to know your worth and refuse to go down the path of universal BB


Dr Matt Harvey   26/07/2025 10:09:25 AM

I doubt the veracity of the modelling. The College has informal survey data via NewsGP that surely must challenge the surprisingly low opt-out prediction.
Surely there will be some who opt in, be confronted by the reality of the lack of financial viability and the resultant forced choice between quality and quantity as bases for their care model, then opt out.
There is a minefield of complexity in PIP distribution; service entity fee structures; practitioner entity autonomy; the scenario of clinician practice employees masquerading (from ATO and SRO POVs) as sole trader contractors; consequent ATO and State Revenue compliance problems; economic pressures (in the unlikely event the UBB model becomes widely prevalent) that may arguably form an effective financial compulsion to adopt the Govt model which (after Wong in the High Court) might warrant consideration as civil conscription.

My recommendation, same as the others: Avoid. Say No. Give high quality for a reasonable fee.


Dr Shobha Balu   27/07/2025 11:29:31 AM

I have recently walked out of my own solo Specialist GP practice of 44 years in the Blue Mountains. As time went on, more and more patients were requesting to be bulk billed. The income was not adequate to pay myself and my staff which included a part time practice nurse and a front desk receptionist. So I made the decision of closing my practice which I did. I miss practising medicine.I have decided to possibly teach the modalities like , prolotherapy, nutritional medicine , acupuncture etc to interested GPs overseas.


Dr Gary John Nicholls   7/08/2025 8:47:12 PM

This 'headline' seems very mis-representative of what GP colleagues are saying across the Country. I don't know anyone in Sydney considering a bulk billed model. It will be interesting to hear what Members of the College feel about this (and the Colleges' response to the ongoing 'GPs will bulk bill' ideology) at the RACGP Conference in Brisbane this year.


Dr Andrew Milne   17/08/2025 10:01:05 AM

Only 23% sounds very low. Does that mean 77% of GP practices in Australia are run by corporates? Is the 50-50 split between employer (cough splutter we are contractors) and GP is a quid pro quo for the uptake?
RACGP is loosing its relevance as a body for all GPs if it cannot show stronger ability to defend our rights. Unfortunately, if the numbers in the article are correct (and who really knows?) then the government owns us and we should ask to become employees of the local health networks to gain access to collective bargaining and the perks of an employee.