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A new analysis by Cleanbill casting doubt on the likely impact and uptake of the Federal Government’s bulk billing reforms has been described as ‘fundamentally flawed’ by Federal Health and Ageing Minister Mark Butler.
The online health directory released a new assessment on Sunday, suggesting only 740 general practice clinics nationwide will move to full bulk billing under the Government’s flagship initiative to boost the number of consultations with no out-of-pocket fees.
These will expand a tripled bulk-billing incentive for concession card holders to all Medicare-eligible patients in November, as well as introduce a 12.5% loading payment on rebates for practices that bulk bill every patient.
Based on an analysis of fees for a standard item 23 consultation, Cleanbill predicts the number of clinics that bulk bill all patients will rise from 1341 to 2081, well below the Government’s election pledge of 4800 GP clinics bulk billing every patient by 2030.
According to the report, the effect of the expansion would need to be between 20% and 30% greater than the Medicare payments published by the Government ‘for it to make economic sense for 4800 clinics to become fully bulk billing’.
The bulk billing incentive program remains controversial for many GPs.
However, Minister Butler strongly disputed Cleanbill’s conclusion.
‘This is a headline-grabbing phone poll conducted by a private company whose own website says their data is not “reliable, accurate, complete or suitable”,’ he told newsGP.
‘Their analysis is fundamentally flawed and should not be reported as accurate.’
Minister Butler also doubled down on the Government’s pre-election pledge that nine out of 10 GP visits would be bulk billed by 2030.
‘Our policy is modelled by the Department and based on actual Medicare data,’ he said.
‘We know this investment will work, because it has already worked for the patients the incentive already applies to: pensioners, concession cardholders, and families with kids.’
The Government said the ‘greatest flaw’ in Cleanbill’s estimate is the assumption that if a GP clinic does not bulk bill all services for non-concession card holders, then it would not bulk bill any service for any patient.
‘This incorrect assumption drives their claim that the payment from Medicare needs to be bigger than the clinics fees to test if the clinic is to be financially better-off fully bulk billing,’ it said.
However, the Cleanbill report comes after advice given to Minister Butler by his own department following the Federal Election in May estimated almost a quarter of clinics are unlikely to join the Bulk Billing Practice Incentive Program.
‘Some patients will still face out-of-pocket costs,’ stated the briefing from DoHDA Secretary Blair Comley.
‘The Department estimates that 23% of clinics are unlikely to join the 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.’
RACGP President Dr Michael Wright said the college and the Government shared the aim ‘for everyone to have access to affordable care from a GP who knows them and their history’.
’We’ll continue to work with the Government to ensure it can successfully deliver access to affordable general practice care for all Australians,’ he said.
‘This is an opportunity to ensure Medicare is strong and can provide the care our patients need, now and into the future.
‘It’s a big challenge after the Medicare rebate freeze and long-term underinvestment in primary care by successive governments.
‘The $8.5 billion increase in funding the Government has committed to shows it’s serious and it understands the scale of investment needed.’
The DoHDA is hosting a series of webinars on the program with detail on financial modelling taking place next month.
