Latest news with #Cleanbill
The Advertiser
3 days ago
- Health
- The Advertiser
Bulk bill incentive could miss thousands of GP clinics
A plan to boost the number of fully bulk-billing general practice clinics is likely to fall dramatically short of forecasts, a healthcare directory operator warns. Labor's $7.9 billion plan to expand the Bulk Billing Incentive Program to include non-concession patients projected the number of fully bulk-billing GP clinics to rise to 4800. But healthcare directory operator Cleanbill estimates the number of entirely bulk-billing clinics will rise by just 740 to 2081 because incentive payments will not cover consultation costs for certain clinics. Federal Health Minister Mark Butler slammed the report as inaccurate and fundamentally flawed. "This is a headline-grabbing phone poll conducted by a private company whose own website says their data is not 'reliable, accurate, complete or suitable'," Mr Butler said in a statement. "For the first time, Labor will expand bulk-billing incentives to all Australians and create an additional new incentive payment for practices that bulk bill every patient." From November 1, clinics that bulk bill every patient will receive a 12.5 per cent payment for each consultation, along with a conditional, variable payment depending on the clinic's remoteness. The report found it would only make sense for clinics to accept the Bulk Billing Incentive if their out-of-pocket costs were lower than the national average, or if they were more remote and attracted a higher incentive contribution. "The vast majority (72 per cent) of GP clinics are located in metro areas, where the New Total Medicare Payment is still $16 below the current average total cost of a non-bulk-billed standard consultation," the Cleanbill report said. It estimated the economic effect of the Bulk Billing Incentive expansion would need to be between 20 per cent and 30 per cent greater than the actual amount of the incentive payment for 4800 clinics to become fully bulk-billing as a result of the change. Patients whose clinics did not switch to fully bulk billing would face higher out-of-pocket costs in future, Cleanbill said. The federal health department said the report was based on a false assumption that if a GP did not bulk bill every patient, they bulk billed none. A plan to boost the number of fully bulk-billing general practice clinics is likely to fall dramatically short of forecasts, a healthcare directory operator warns. Labor's $7.9 billion plan to expand the Bulk Billing Incentive Program to include non-concession patients projected the number of fully bulk-billing GP clinics to rise to 4800. But healthcare directory operator Cleanbill estimates the number of entirely bulk-billing clinics will rise by just 740 to 2081 because incentive payments will not cover consultation costs for certain clinics. Federal Health Minister Mark Butler slammed the report as inaccurate and fundamentally flawed. "This is a headline-grabbing phone poll conducted by a private company whose own website says their data is not 'reliable, accurate, complete or suitable'," Mr Butler said in a statement. "For the first time, Labor will expand bulk-billing incentives to all Australians and create an additional new incentive payment for practices that bulk bill every patient." From November 1, clinics that bulk bill every patient will receive a 12.5 per cent payment for each consultation, along with a conditional, variable payment depending on the clinic's remoteness. The report found it would only make sense for clinics to accept the Bulk Billing Incentive if their out-of-pocket costs were lower than the national average, or if they were more remote and attracted a higher incentive contribution. "The vast majority (72 per cent) of GP clinics are located in metro areas, where the New Total Medicare Payment is still $16 below the current average total cost of a non-bulk-billed standard consultation," the Cleanbill report said. It estimated the economic effect of the Bulk Billing Incentive expansion would need to be between 20 per cent and 30 per cent greater than the actual amount of the incentive payment for 4800 clinics to become fully bulk-billing as a result of the change. Patients whose clinics did not switch to fully bulk billing would face higher out-of-pocket costs in future, Cleanbill said. The federal health department said the report was based on a false assumption that if a GP did not bulk bill every patient, they bulk billed none. A plan to boost the number of fully bulk-billing general practice clinics is likely to fall dramatically short of forecasts, a healthcare directory operator warns. Labor's $7.9 billion plan to expand the Bulk Billing Incentive Program to include non-concession patients projected the number of fully bulk-billing GP clinics to rise to 4800. But healthcare directory operator Cleanbill estimates the number of entirely bulk-billing clinics will rise by just 740 to 2081 because incentive payments will not cover consultation costs for certain clinics. Federal Health Minister Mark Butler slammed the report as inaccurate and fundamentally flawed. "This is a headline-grabbing phone poll conducted by a private company whose own website says their data is not 'reliable, accurate, complete or suitable'," Mr Butler said in a statement. "For the first time, Labor will expand bulk-billing incentives to all Australians and create an additional new incentive payment for practices that bulk bill every patient." From November 1, clinics that bulk bill every patient will receive a 12.5 per cent payment for each consultation, along with a conditional, variable payment depending on the clinic's remoteness. The report found it would only make sense for clinics to accept the Bulk Billing Incentive if their out-of-pocket costs were lower than the national average, or if they were more remote and attracted a higher incentive contribution. "The vast majority (72 per cent) of GP clinics are located in metro areas, where the New Total Medicare Payment is still $16 below the current average total cost of a non-bulk-billed standard consultation," the Cleanbill report said. It estimated the economic effect of the Bulk Billing Incentive expansion would need to be between 20 per cent and 30 per cent greater than the actual amount of the incentive payment for 4800 clinics to become fully bulk-billing as a result of the change. Patients whose clinics did not switch to fully bulk billing would face higher out-of-pocket costs in future, Cleanbill said. The federal health department said the report was based on a false assumption that if a GP did not bulk bill every patient, they bulk billed none. A plan to boost the number of fully bulk-billing general practice clinics is likely to fall dramatically short of forecasts, a healthcare directory operator warns. Labor's $7.9 billion plan to expand the Bulk Billing Incentive Program to include non-concession patients projected the number of fully bulk-billing GP clinics to rise to 4800. But healthcare directory operator Cleanbill estimates the number of entirely bulk-billing clinics will rise by just 740 to 2081 because incentive payments will not cover consultation costs for certain clinics. Federal Health Minister Mark Butler slammed the report as inaccurate and fundamentally flawed. "This is a headline-grabbing phone poll conducted by a private company whose own website says their data is not 'reliable, accurate, complete or suitable'," Mr Butler said in a statement. "For the first time, Labor will expand bulk-billing incentives to all Australians and create an additional new incentive payment for practices that bulk bill every patient." From November 1, clinics that bulk bill every patient will receive a 12.5 per cent payment for each consultation, along with a conditional, variable payment depending on the clinic's remoteness. The report found it would only make sense for clinics to accept the Bulk Billing Incentive if their out-of-pocket costs were lower than the national average, or if they were more remote and attracted a higher incentive contribution. "The vast majority (72 per cent) of GP clinics are located in metro areas, where the New Total Medicare Payment is still $16 below the current average total cost of a non-bulk-billed standard consultation," the Cleanbill report said. It estimated the economic effect of the Bulk Billing Incentive expansion would need to be between 20 per cent and 30 per cent greater than the actual amount of the incentive payment for 4800 clinics to become fully bulk-billing as a result of the change. Patients whose clinics did not switch to fully bulk billing would face higher out-of-pocket costs in future, Cleanbill said. The federal health department said the report was based on a false assumption that if a GP did not bulk bill every patient, they bulk billed none.
West Australian
3 days ago
- Health
- West Australian
Bulk bill incentive could miss thousands of GP clinics
A plan to boost the number of fully bulk-billing general practice clinics is likely to fall dramatically short of forecasts, a healthcare directory operator warns. Labor's $7.9 billion plan to expand the Bulk Billing Incentive Program to include non-concession patients projected the number of fully bulk-billing GP clinics to rise to 4800. But healthcare directory operator Cleanbill estimates the number of entirely bulk-billing clinics will rise by just 740 to 2081 because incentive payments will not cover consultation costs for certain clinics. Federal Health Minister Mark Butler slammed the report as inaccurate and fundamentally flawed. "This is a headline-grabbing phone poll conducted by a private company whose own website says their data is not 'reliable, accurate, complete or suitable'," Mr Butler said in a statement. "For the first time, Labor will expand bulk-billing incentives to all Australians and create an additional new incentive payment for practices that bulk bill every patient." From November 1, clinics that bulk bill every patient will receive a 12.5 per cent payment for each consultation, along with a conditional, variable payment depending on the clinic's remoteness. The report found it would only make sense for clinics to accept the Bulk Billing Incentive if their out-of-pocket costs were lower than the national average, or if they were more remote and attracted a higher incentive contribution. "The vast majority (72 per cent) of GP clinics are located in metro areas, where the New Total Medicare Payment is still $16 below the current average total cost of a non-bulk-billed standard consultation," the Cleanbill report said. It estimated the economic effect of the Bulk Billing Incentive expansion would need to be between 20 per cent and 30 per cent greater than the actual amount of the incentive payment for 4800 clinics to become fully bulk-billing as a result of the change. Patients whose clinics did not switch to fully bulk billing would face higher out-of-pocket costs in future, Cleanbill said. The federal health department said the report was based on a false assumption that if a GP did not bulk bill every patient, they bulk billed none.
Perth Now
3 days ago
- Health
- Perth Now
Bulk bill incentive could miss thousands of GP clinics
A plan to boost the number of fully bulk-billing general practice clinics is likely to fall dramatically short of forecasts, a healthcare directory operator warns. Labor's $7.9 billion plan to expand the Bulk Billing Incentive Program to include non-concession patients projected the number of fully bulk-billing GP clinics to rise to 4800. But healthcare directory operator Cleanbill estimates the number of entirely bulk-billing clinics will rise by just 740 to 2081 because incentive payments will not cover consultation costs for certain clinics. Federal Health Minister Mark Butler slammed the report as inaccurate and fundamentally flawed. "This is a headline-grabbing phone poll conducted by a private company whose own website says their data is not 'reliable, accurate, complete or suitable'," Mr Butler said in a statement. "For the first time, Labor will expand bulk-billing incentives to all Australians and create an additional new incentive payment for practices that bulk bill every patient." From November 1, clinics that bulk bill every patient will receive a 12.5 per cent payment for each consultation, along with a conditional, variable payment depending on the clinic's remoteness. The report found it would only make sense for clinics to accept the Bulk Billing Incentive if their out-of-pocket costs were lower than the national average, or if they were more remote and attracted a higher incentive contribution. "The vast majority (72 per cent) of GP clinics are located in metro areas, where the New Total Medicare Payment is still $16 below the current average total cost of a non-bulk-billed standard consultation," the Cleanbill report said. It estimated the economic effect of the Bulk Billing Incentive expansion would need to be between 20 per cent and 30 per cent greater than the actual amount of the incentive payment for 4800 clinics to become fully bulk-billing as a result of the change. Patients whose clinics did not switch to fully bulk billing would face higher out-of-pocket costs in future, Cleanbill said. The federal health department said the report was based on a false assumption that if a GP did not bulk bill every patient, they bulk billed none.
The Guardian
04-06-2025
- Business
- The Guardian
More Australians can't afford specialist fees. Experts say it's ‘not in the spirit of Medicare'
The cost of an initial dermatology appointment is now up to nearly $300 on average, new data shows. It reflects a broader problem: that Medicare rebates are not keeping up with the pace specialist fees are rising. Online healthcare directory Cleanbill, which has tracked bulk billing rates among GPs, is expanding to provide data on out-of-pocket costs to see other health professionals, starting with dermatology. The report, released on Thursday, found the Medicare rebate in March 2017 for an initial appointment with a dermatologist was $72.75, while the out-of-pocket cost was $148.73. By March 2025, the rebate had risen by $11.40, to $84.15, while the average out-of-pocket costs, at $210.18, were $61.45 more expensive. Over eight years, average out-of-pocket costs for an initial consultation had increased by over 40%, and average follow-up consultation costs had increased by over 55%. The rebate rose by less than 16%. Cleanbill compared the 2017 data collected by predecessor MindTheGap for 165 dermatology clinics still currently operating, with its own data collected in October. Sign up for Guardian Australia's breaking news email Based on all 280 dermatology clinics Cleanbill identified currently operating, the average upfront cost of an appointment was $296.71 – more than 3.5 times the Medicare rebate. Cleanbill's report highlighted that as private health insurance does not cover out-of-hospital consultations, these out-of-pockets costs are being borne entirely by patients. Private health insurance mainly covers the cost of private hospital treatment, and may also cover non-Medicare subsidised services such as physiotherapy, psychology and dental services – but not GP or specialist consultations. 'These out-of-pocket costs far exceed the increases that we've seen to the Medicare rebate,' Cleanbill's chief executive, James Gillespie, said. 'In these circumstances, it's easy to see why the number of Australians putting off specialist care due to cost has risen from 176,000 in 2016-17 to 900,000 in 2023-24,' he wrote in the report, citing Australian Bureau of Statistics data. Many specialist services are available to patients for free in public outpatient clinics, but patients need a referral from their GP to qualify, and each hospital or specialist clinic has its own process for assessing urgency, accepting referral letters and making appointments. A GP referral is needed to claim the Medicare rebate at a specialist appointment, meaning a second round of out-of-pocket costs that 'stacks one on top of the other', Gillespie said. Gillespie said it was reasonable to extrapolate similar price increases across other medical specialists than dermatologists. The latest government data on medical specialist consultations showed patient out-of-pocket costs in non-hospital settings increased in real terms (adjusting for inflation) from $1.1bn in 2012-13 to $1.9bn in 2022-23 – or 'from $213 per patient to $294 (38%)'. In the same period, Medicare benefits paid by the government increased in real terms from $2.5bn to $2.9bn – or 16%. The government this year promised $7m to expand the much-derided Medical Costs Finder website, which the former Coalition government spent $24m setting up to see only 70 specialists – out of 11,000 registered to practice – choose to voluntarily display their fee information as of March 2025. Prof Yuting Zhang, an expert in health economics at the University of Melbourne, said providing cost information was only a first step – and the government had not outlined a policy to lower fees. Zhang and her colleagues at the Health Analytics, Leadership and Economics Hub mapped specialist fees in 2023 across different areas, finding on average that rheumatology had the highest fees, followed by neurology and immunology. Specialist fees have gone up 'a lot' but the Medicare schedule fee hasn't been properly indexed, Zhang said, remaining 'quite flat' for about the last 20 years, leaving patients to absorb the increasing gap. Sign up to Breaking News Australia Get the most important news as it breaks after newsletter promotion Some fees were 'super high' at about $1,200 but cost varied widely even within the same specialty for exactly the same services, she said. 'Some people might be willing to pay a lot more to see a specialist and thinking the price might be an indicator for quality – which I can assure you, it's never the case,' Zhang said. 'More expensive doesn't really mean better.' A third of people living with chronic diseases say they are not able to attend specialist appointments due to the cost, a study published in May in the journal Health Policy found, with both the upfront cost and out-of-pocket costs being a major barrier to care. Australian National University researchers analysed the experiences of more than 1,800 Australians living with a range of chronic conditions within 37 studies. Assoc prof Jane Desborough, the lead author of the study, said while GPs face 'consistent pressure' to bulk-bill, backed by policy initiatives, there is 'no similar conversation about non-GP specialists who are also trained in the public system, who are also remunerated through Medicare … yet from the evidence, it seems quite uncommon for them to bulk-bill'. Many Australians with multiple chronic conditions often need to see several different specialists; even a person with a single chronic condition such as psoriatic arthritis needs both a dermatologist and rheumatologist. Those who struggled to afford specialist appointments reported often choosing who they saw based on 'what's hurting most at the time', Desborough said. Chronic illness often impacts people's capacity to work. The frustration of not being able to afford specialist visits is compounded by the long wait list for public specialist clinics, she said, as well as an increased trend by specialists towards exclusive private practice. Those who had full access to the specialist clinics in the public system were 'very grateful for what Medicare does,' Desborough said. But as for others, having to forego important aspects of their life – like food choices, social activities, family holidays, children's sport, school excursions – to access healthcare: 'That's not in the spirit of Medicare,' she said. The health minister, Mark Butler, said the private health sector, including insurers and specialists, 'need[s] to do more to protect patients for exorbitant bills'. Zhang said specialist medical colleges could play a role, by developing codes of conduct around fee practices and scrutinising members who consistently charge high fees. The government could also open more public clinics offering free specialist care for those who cannot afford the gap fees in private clinics, Zhang said.
The Guardian
08-02-2025
- Business
- The Guardian
No bulk billing GPs found in 10% of federal electorates for standard consultations, survey says
An adult without concessions would not be able to find a bulk billing GP in 10% of electorates, according to a new report. Online healthcare directory Cleanbill on Sunday released an electorate breakdown of its third annual Blue Report based on a survey of 6,925 general practices carried out during October 2024. The Blue Report, published earlier in January, found for new adult patients without a concession card, four out of five GPs will charge a gap fee. Cleanbill collects its information, according to its founder, James Gillespie, by compiling a list of general practices nationally, which they call to ensure they are an operating GP clinic, ask if they bulk bill adult patients and, if not, what out-of-pocket fees they charge. Data managers then check that information against what is stated on clinics' websites and repeat calls until they can ensure consistent information. When it comes to what is happening across the 151 commonwealth electoral divisions, Cleanbill was unable to find any available bulk billing clinics for adult patients in 15 electorates, compared to four in its first report in 2023. Sign up for Guardian Australia's breaking news email Those 15 electorates were Bass (Tasmania), Boothby (South Australia), Braddon (Tasmania), Brisbane (Queensland), Clark (Tasmania), Fairfax (Queensland), Franklin (Tasmania), Jagajaga (Victoria), Kingston (SA), Lyne (New South Wales), Lyons (Tasmania), Mayo (SA), Newcastle (NSW), Shortland (NSW) and Swan (Western Australia). The report found there were still 12 electorates with bulk billing rates exceeding 50%, of which nine were located in western Sydney. While some electorates have gained bulk billing clinics since 2023, Cleanbill found the majority (86.7%) had fewer with an average drop of 13.7% in the two-year period. The electorate of Burt in WA experienced the greatest decrease in bulk billing rates from 61% in 2022-23, dropping to 6.5% in 2024-25, followed by Gorton in Victoria, dropping from 64% to 15% in the same period. Gilmore in NSW experienced the largest increase in bulk billing clinics, from 10.9% in 2022-23 to 23.5% in 2024-25, followed by Cowper (NSW), which rose from 2.6% to 13.5%, in the same period. Cleanbill found the electorate of Chifley in NSW had the greatest decrease in average out-of-pocket costs, from $50.25 in 2022-23 to $22.92 in 2024-25, followed by Parramatta in NSW, from $56.85 to $35.70 in the same period. Meanwhile, Watson (NSW) saw the largest increase in average out-of-pocket costs, going from $24.54 in 2022-23 to $36.52 in 2024-25, followed by Wide Bay in Queensland, rising from $39.67 to $49.71 in the same period. Dr Christopher Harrison from the Menzies Centre for Health Policy and Economics at the University of Sydney said Cleanbill's results were based on patients not covered by the incentives the government introduced in 2023, which increased the amount that GPs receive when they bulk bill children and concession card holders. Sign up to Breaking News Australia Get the most important news as it breaks after newsletter promotion 'This likely explains why the government can point to a well-documented increase in bulk billing rates overall, while at the same time Cleanbill finds that it has become increasingly difficult for an adult who does not have a concession card to find a GP practice that will bulk bill them. These two results are not contradictory,' Harrison said. There are likely existing patients already on a practice's books who are and will continue to be bulk billed, as well as cases where a patient with financial difficulties could be bulk billed based on GP discretion, he pointed out. 'These data do highlight a growing issue within our healthcare system. A sustainable way to incentivise GPs to bulk bill this patient group needs to be found,' Harrison said. The health minister, Mark Butler, said 'official data shows our record investment to strengthen Medicare has stopped the freefall in bulk billing that was created under the Coalition Government. 'After we tripled the bulk billing incentive for GPs, bulk billing has started rising again in every state and territory – delivering an additional 5.8m free visits to the GP in just 13 months,' Butler said. Nationally, 77.2% of all GP visits were bulk billed in November 2024, an increase of 1.6% from October, before the investment took effect, he said. The president of the Australian Medical Association (AMA), Dr Danielle McMullen, said the Cleanbill report provided a 'limited' snapshot of GP billing practice. 'The Productivity Commission's authoritative report on government services tells a much clearer story – commonwealth spending per person on general practice has declined since 2018/19, and more patients are delaying GP visits due to cost.' The president of the peak body for general practitioners, Dr Michael Wright, said: 'All Australians need affordable access to a GP who knows them. With a federal election fast approaching, we should be seeing bold commitments from all political parties to achieve this.'
