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Do high bulk billing rates reflect real value of care?

Latest Medicare data from July 2017 to March 2018 shows Australian patients have set a new record for the highest GP bulk-billing rate achieved for this period, but do these statistics reflect the true cost of delivering patient-centric care?

Making the announcement, Federal Health Minister Greg Hunt said the record bulk-billing rate of 85.8%, which means more than 65.9 million doctor visits were free for patients during those six months.

According to Hunt, these statistics show more Australians are seeing their doctor without having to pay than ever before.

“More than 97.7 million bulk-billed GP visits were provided to patients over this time period, an extra 3.7 million services compared to last year,” he said.

Medicare’s data also revealed a number of fully subsidised services across Medicare has also risen, with an additional 13 million bulk-billed services delivered compared to last year, with a total of 241 million bulk-billed services.

But Hunt stressed that although more Australians are benefiting from these record figures, it’s time to continue to drive down the cost of private health insurance and address out-of-pocket costs.

“That’s why we’re working with the medical profession to address the large and sometimes unanticipated out-of-pocket medical fees some patients face,” he said. “Last year we brought in the Medicare Guarantee Fund on 1 July 2017, guaranteeing the first call on the Budget, and this year we look forward to delivering more record health funding.”

According to RACGP President Dr Bastian Seidel, while the raw figures for bulk billing may seem impressive, they refer simply to services delivered, not the number of patients, and do not reflect the true costs of general practice care – or its value. The current bulk-billing rate also fails to reflect exactly who is using the services, and how often, he revealed.

“For example, when you look at the percentage of patients who had all their GP visits bulk billed during 2016–17, it was actually around 66%,” he said. “About 12.5% of Australians are frequent GP attenders, accounting for 41% of the Medicare spend on out-of-hospital services. These patients tend to be older, from lower socioeconomic backgrounds and experiencing at least one chronic condition.”

Earlier this year, the RACGP recommended an 18.5% increase of the Medicare rebate for GP consultations to bring them into line with other specialists’ fees.

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