Many health services in Australia are subsidised by the Australian Government. Most GPs and specialists in Australia can set their own service fees and invoice patients directly, patients then claim the benefit from Medicare.
Bulk billing is the practice of doctors choosing to be paid reduced fees by accepting the Medicare benefit directly rather than bill patients. GP consultations allow a 100% benefit of the Medicare Benefits Schedule (MBS) fee. Although, now it appears that GP bulk billing rates are on the rise. So, what does this mean for you?
Medicare Benefits Schedule fees have been indexed each year since the MBS was introduced in 1984, however in May 2013 the government announced a change to indexation in order to lessen the burden on the health care system and provide budget savings.
Further changes meant that as of July 2014 MBS fees for all doctors and health professionals would be frozen until July 2018 and longer for specialists. Despite this freeze, Medicare bulk billing rates have increased and are now at an all-time high with 85.1% of non-referred GP services being fully funded under Medicare in the last financial year.
The reason for the increase in Medicare bulk billing rates, despite the freeze is unclear. It could be that GPs are absorbing the rise in costs due to indexation instead of passing them on to patients. Some practices may have chosen not to increase staff wages in order to offset the rebate freeze. With modern technology, bulk billing the government via the patient’s Medicare card can offer savings in both time and convenience than when billing clients directly.
GP bulk billing rates may have increased due to an increased number of doctors practicing and offering more services which has resulted in more competition. Patients on low or fixed incomes, such as pensioners or those with chronic diseases who make up the majority of GP bulk-billed patients, will invariably choose to see a doctor who bulk-bills than one who does not.
Because services can choose whether or not to bulk-bill, some GPs bulk-bill for certain patients only such as pensioners, children and/or Health Care Card holders, or only for certain services. The growing ageing population may be behind the increased GP bulk billing rates. Bulk billing is less likely to be offered in more affluent areas, and also rural or remote areas where there is a shortage of doctors and health care services.
As a result of the freeze some practices have chosen to continue to offer Medicare bulk billing for long-term clients but direct bill new clients. At this stage the freeze has only been in place for two years and it may be that the full impact on the Medicare bulk billing rates is yet to be revealed.