RACGP Medicare funding webinar: A recap

Hundreds of RACGP members tuned in for the college’s national funding webinar last week, aimed at explaining and discussing a range of Federal Government plans to overhaul Medicare and billing.
 
The webinar, which RACGP members can now watch back in full, discusses the potential changes in detail, shares members’ feedback, answers members’ questions, and forecasts what could happen next and how members can contribute.
 
It also examines a range of scenarios to determine how different kinds of practices could be affected.
 
The webinar comes after the Federal Government announced a $8.5 billion boost to Medicare funding, if elected at the looming Federal Election, which would see ‘nine out of 10 visits to the GP be free’.
 
It also included several workforce and training funding pledges to expand GP training, fund salary incentives for junior doctors to specialise in general practice, and provide paid parental leave and study leave for GP trainees.
 
The promise was swiftly matched by the Coalition.
 
However, this plan has caused widespread concerns and questions from the country’s GPs, leading the RACGP to hold its webinar to help doctors better ‘understand the proposed changes and prepare for what lies ahead’.
 
RACGP President Dr Michael Wright was joined by practice owner and RACGP NSW&ACT Chair Dr Rebekah Hoffman and Cubiko Chief Executive Chris Smeed for the event.
 
‘As Australia’s largest medical college representing more than 50,000 members, we come from a strong base when advocating on behalf of general practice, but we need to represent you properly, and so without events like this, we can’t do that,’ Dr Wright told the webinar audience.
 
‘While some of it hasn’t been targeted in the way that the RACGP has requested, it nonetheless represents the most significant investment in Medicare in its 40-year history, and the significant value that politicians are beginning to place on general practice and our role in the health system.
 
‘We said repeatedly that, given the complexity of these changes, we wanted to speak to you, the members, to understand the implications of these proposals, and that’s what we’re trying to do tonight.’
 
Dr Wright said he has heard from members who are supportive of the measures, but most of the feedback has been ‘cautious, if not stronger than that’.
 
According to the webinar, initial member feedback saw a range of responses, including fears the changes will become a driver of short consults, concern over the impacts of the worsening gender pay gap, sustainability, and loss of autonomy.
 
‘The main criticisms around this Medicare bulk billing announcement was that it’s giving the same incentives for all types of consults, and therefore it’s going to be a driver to encourage short consultations as standard as opposed to long,’ Dr Wright said.
 
‘This is at a time when the college has been working hard to shift the focus of Medicare and its funding towards chronic and complex care, and we’ve been calling for increased patient rebates for longer consultations and mental health consultations in particular.
 
‘Most people we’ve spoken to are concerned about the patient expectations regarding bulk billing, and how these incentives might encourage faster medicine over more holistic and comprehensive care.
 
‘The college has listened to your calls for us to advocate strongly for general practice.’
 
Dr Hoffman then shared her own experience as a Sydney practice owner, saying when she first heard the funding proposals, she ‘went through all of the stages of grief’.
 
‘I went through denial, I went through being really, really angry and upset,’ she said.
 
‘I tried to have a look at the opportunity and really understand and appreciate the opportunity for some practices across Australia, and for some that will mean that not only are they viable, but they’ll actually have a greater source of income.
 
‘That’s not going to be the case for my practice.’
 
But Dr Hoffman ultimately said with some uncertainty remaining about the proposed changes and their rollout, GPs must be ‘dynamic and move with the local community’.
 
‘Keep listening to them and keep talking to them, and hope that we provide a service that they’re happy to pay for,’ she said.
 
Mr Smeed, who was also a Brisbane practice manager, then provided an in-depth analysis of several different scenarios which could play out under the Medicare changes.
 
‘I’ve been through the tough times … shifting my patient cohort from bulk billing, to mixed billing, and private billing,’ he said.
 
Mr Smeed’s scenarios included an analysis of applying the bulk-billing incentives to patients who GPs are already bulk billing but do not get the incentive, and practices moving to or already universally bulk billing.
 
His detailed explanations of these scenarios are provided in full in the webinar.
 
A Q&A discussion ended the webinar, with the answers added to the RACGP’s updated FAQs page.
 
Mr Smeed has also provided the link to an Excel tool which practices can download to use the same modelling he used during the event. 
 
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