Every electorate in the country will have a GP practice that bulk bills every patient after the expanded bulk billing incentive came into effect this month, the health minister has said.
The changes mean four out of 10 practices will be fully bulk billing, as the government vows it will bring the number up to nine out of 10 by 2030.
However, the peak body for general practitioners said many remain nervous about switching back to a system that relies on government funding.
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Over 1,000 GP practices that were previously mixed billing have signed up to become fully bulk billing, the health minister, Mark Butler, said.
With 1,600 pre-existing fully bulk billing practices, the expansion brings the number to more than 2,600 out of 6,500 GP practices nationally, Butler said.
Fulfilling a major election promise, Labor expanded the bulk-billing incentive to all Australian Medicare cardholders and gave clinics who bulk billed every patient an additional loading payment of 12.5% on their rebates.
Butler said “every electorate in the country will now have GP practices that bulk bill every patient”.
A report by health directory Cleanbill released in February showed there were previously no fully bulk billing practices in one in 10 electorates, including all five of Tasmania’s.
Cleanbill released an electorate breakdown on Wednesday showing whether it would make economic sense for clinics to make the transition to become fully bulk billing by comparing a clinic’s current standard consultation fees to the relevant value of the new Medicare payment.
Its most conservative estimate suggested there would be at least one fully bulk billing clinic in all electorates except for Clark in Tasmania and Shortland in New South Wales.
A spokesperson for the health minister has confirmed there are four mixed billing clinics that will transition to fully bulk billing in Clark and Shortland.
The chief executive of Cleanbill, James Gillespie, said there were many clinics across the country where “they were right on the edge, charging 30c more than they would receive under the bulk billing incentives”.
The report acknowledged the analysis couldn’t guarantee practices would take up the incentives as decisions involved complex factors, such as state-level tax rebates, and whether new practices were trying to incentivise more patients .
Because the incentive payments scale higher the more remote the practice, Gillespie said the data showed a pattern of lower uptake by practices in metropolitan areas which receive the lowest incentives, while having high average total costs.
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In the electorate of Shortland, for example, Gillespie said the incentive in would provide nearly $70 for a standard consultation, but Cleanbill’s data showed the average consultation cost was $90.87.
Two in five clinics intending to move from mixed to fully bulk billing are in regional centres, according to the government. Out of 40 practices in Ballarat for example, eight were previously bulk billing and an additional 18 have indicated they will switch from mixed billing to bulk billing.
Dr Alan Bradley, a GP in metropolitan Melbourne, said the clinic where he works had not switched to fully bulk billing because “to make the maths work, you would have to essentially double the amount of patients you see per hour”.
“I would be surprised if any fully private metro clinic changes, because it essentially incentivises six to 10 minute appointments and quick turnaround,” Bradley said.
Dr Michael Wright, the president of the Royal Australian College of General Practitioners said the largest increase in Medicare investment in years was welcome.
“But as the Department of Health’s modelling shows, they won’t work for all practices,” Wright said.
“After a near decade-long Medicare freeze and years of chronic underfunding, many GPs are nervous about switching back to a system that once again makes them 100% reliant on government funding decisions.”
“For these GPs, this decision is fundamentally a trust issue, not just a financial one.” ”
Disclaimer : This story is auto aggregated by a computer programme and has not been created or edited by DOWNTHENEWS. Publisher: theguardian.com
