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The bulk billing incentive explained

By Dr. Philip | 29 June 2023

It seems awhile ago that we promised to keep the public up to date with the change in billing policy at Foster and Toora Medical Centres. In fact, it was just before the Federal budget. Which certainly surprised with the headline-grabbing ‘triple bulk billing incentive’ package for GPs. That was a significant announcement… but in the end more a band-aid on a chronically broken system than the major change ‘to stop the fall of bulk billing rates’ that it was trumped up to be.

There is quite a deal of confusion as to what the tripling of these bulk billing incentives are. 

So let us explain. The bulk billing incentive is a small incentive provided to doctors who bulk bill patients from vulnerable patient groups. The amount differs depending on location (more in isolated regions, less in regional towns, less again in the city). It is not a rebate paid to you as the patient and not all services provided by doctors are eligible for the bulk billing incentive. 

From November 1 the incentive will be tripled on a certain small but common number of item numbers. This is good, no doubt, but once again the Medicare rebate did not change; this continues a neglect that has occurred over decades, by successive governments, that have totally eroded your Medicare rebates.

Once upon a time, the standard Medicare rebate was a reasonable amount of money for the work your GPs do. Repeated indexation below inflation and the rebate freeze have left this amount far lower than the cost of providing proper GP care. In fact, through a combination of internal and external analyses, we have estimated that the rebate now equates to approximately half of what the actual cost of the care is. And here’s the sting-even with the tripling of the bulkbilling incentive, many external analyses show that most doctors will still incur a loss when they bulkbill. 

So, what does all that mean locally?

It has been decided that, despite the above, at present FMC and TMC will continue to bulkbill certain groups (children under 16, Pensioners and Health Care Card holders and DVA) and reassess in the future whether this is a financially sustainable model. 

But we can only continue to offer this if the non-vulnerable groups are not bulkbilled. So, from July 1, even if your doctor has often or always bulk billed your consultations, if you donot have a health care card or pension card, standard consultations can no longer be routinely bulk billed. (Some of the more complex consultations with higher rebates such as care plans will continue to be bulk billed at this stage). We know that, over the years, much of the bulkbilling occurs at our practice in patients who are outside those aforementioned groups (eg. friends, team mates, distant relatives, fellow health care workers, etc). This stops July 1 …and this will allow us to continue bulkbilling the vulnerable groups.

We hope for your understanding. Our priority is to continue to deliver the very best of medical care to our community, both now and for the future. To do that we need a sustainable medical model and also, importantly, one that will be attractive to up-and-coming young doctors. We live in a time where there are not enough GPs in training to meet the need (not by a long shot!) and where nearly every town and practice is short and recruiting.