From 1 November 2023, the changes to bulk billing mean that General Practitioners (GP) will receive a triple incentive to bulk bill vulnerable patient groups for most standard GP consultations.

In metro locations, the incentive will rise from $6.85 to $20.65 and in very remote locations this will increase from $13.15 to $39.65. The incentive is scaled for those between metro and very remote locations using the Modified Monash Model.

Vulnerable patient groups

Vulnerable patient groups, including children under 16 and Commonwealth concession card holders (totalling more than 11.6 million people), are the focus of a $3.5 billion initiative to triple the bulk billing incentive for GPs in Australia. The aim is to address a decline in bulk billing and provide support to GPs in covering individuals facing cost of living pressures, particularly those in regional, rural, and remote communities, and concession card holders who often have higher healthcare needs and socioeconomic disadvantage.

What types of consults do the changes to bulk billing apply to?

The changes to bulk billing incentives apply to standard GP consultations with eligible vulnerable patient groups.

Standard GP consultations include:

All face-to-face general attendance consultations that are:

• longer than 6 minutes (that is Levels B, C, D and E)

• in any location (in and out of consulting rooms, residential aged care facilities)

• at any time (business and after-hours items)

MBS Level B video and telephone general attendance consultations

Video and telephone consultations that are:

• longer than 20 minutes (Levels C, D and E (video only)) and

• the patient is registered with the practice through MyMedicare.

It is worth noting that in order to claim the incentive on telehealth appointments of longer than 20 minutes the patient must be registered with the practice through MyMedicare.

What this means for your medical practice and patients

Financial impact and revenue increase

The tripling of the bulk billing incentive may have a positive financial impact on some medical practices. The increased incentive, particularly for consultations with children under 16 and Commonwealth concession card holders, can result in higher Medicare benefits for bulk-billed services. This may lead to an increase in revenue for some medical practices, providing additional financial support and potentially improving the overall financial health of the practice.

It is important to note that financial impact is very much determined by the medical practices current billing arrangements. If the medical practice is already bulk-billing the vulnerable patient groups, they may see an increase in revenue. If they are not currently bulk-billing this cohort, the impact of the change will have less effect.

Reduced financial pressure on vulnerable patient groups

The initiative is aimed at alleviating financial pressures on vulnerable patient groups, GPs are incentivised to continue or commence bulk billing these patient groups, ensuring that individuals facing cost-of-living pressures can access primary care services without incurring significant out-of-pocket expenses. This, in turn, may contribute to better health outcomes for these populations.

What should you do now?

Reviewing your medical practice fee structure in light of the new changes to bulk billing incentives is crucial to ensuring your practice is optimally positioned to provide affordable healthcare to patients while maximising profitability. Findex, with its expertise in the medical industry around the country, can assist your practice in this process.

We offer specialised services to evaluate and determine an appropriate fee structure for your practice’s needs. By assessing the right mix of fees and bulk billing, we can help ensure that your practice achieves the desired outcomes in terms of cost-effectiveness for both patients and associate doctors.

Contact our Advisory team today to navigate the evolving healthcare landscape and maintain a balance between patient accessibility and practice profitability.

Disclaimer:

The title 'Partner' conveys that the person is a senior member within their respective division and is among the group of persons who hold an equity interest (shareholder) in its parent entity, Findex Group Limited. The only professional service offering which is conducted by a partnership is external audit, conducted via the Crowe Australasia external audit division and Unison SMSF Audit. All other professional services offered by Findex Group Limited are conducted by a privately-owned organisation and/or its subsidiaries.