The latest tranche of data from Medicare backs Minister Butler’s claims of a rise in GP bulk billing, to a point.
GPs appear to be picking up what the government is putting down when it comes to bulk billing under 16s and over 65s – and it’s been just enough to lift the overall bulk-billing rate.
Medicare’s quarterly statistics to September 2024 have arrived, confirming federal Health Minister Mark Butler’s announcement last week that bulk-billing rates have turned a corner.
It has pegged the national GP non-referred attendance bulk-billing rate for the year to date as 77.6%, an improvement of one percentage point on the same time last year.
This is slightly higher than what Mr Butler announced as the October 2024 bulk-billing rate last week; the disparity can be explained by the fact that Mr Butler was quoting a rate averaged over one month, whereas Medicare’s data is averaged over three months.
It’s also worth noting that 77.6% is only an increase when compared to last September’s year-to-date bulk-billing average of 76.5%.
Pre-pandemic, bulk-billing rates were consistently greater than 80%.
While the overall bulk-billing rate only shifted by one percentage point, there were bigger shifts in the patient cohorts that attracted bulk-billing incentives.
In the three months to September 2023, before the bulk-billing incentive was tripled, under 16s were bulk billed for 87.4% of services; for the same time period in 2024, the rate was 89.9%, making for a 2.5 percentage point rise.
The same was true for Australians older than 64.
In the September quarter 2023, they were bulk billed for 84.6% of services and in the September quarter 2024, they were bulk billed for 87.2% of services.
This made for a 2.6 percentage point rise in bulk billing for over 64s.
The increase in these two groups appears to be what drove the overall one percentage point increase, because the 16 to 64-year-old bulk-billing rate dropped by about 0.5 percentage points between September quarter 2023 and September quarter 2024.
This cohort includes some people who were eligible for the bulk-billing incentive – namely those on low incomes.
To this end, bulk-billing rates were highest for the 16-to-64 cohort in the most socio-economically disadvantaged regions, at 82.2%, and lowest in the least disadvantaged areas, at 55.9%.
This would suggest that the tripled bulk-billing incentive is having an impact on GP billing behaviour, but perhaps only in relation to patients who are eligible for the increased rebates.
If the goal was to safeguard bulk billing for the specific cohorts covered by the incentive, then it appears to be working.
Related
If the goal was for GPs to use the additional money from bulk bulling patients covered by the incentive to cover their shortfalls and increase bulk billing across the board, then it appears to have failed.
Chronic disease and complex care attendances were the most likely services to be bulk billed, while Level E consults were the least likely to be bulk billed.
This potentially reflects the fact that Medicare rebates decrease on a cash-per-minute basis as the length of service increases.
Geographically speaking, the ACT was the primary health network area with the lowest GP bulk-billing rate in the country, at 52.9%.
Southwestern Sydney, meanwhile, has the highest bulk-billing rate in Australia at 93.9%.
These rankings are roughly consistent with previous years; Canberra has historically had a low bulk-billing rate while southwestern Sydney has historically had a high bulk-billing rate.
