The cost of freezing general practice

Harrison, Christopher; Bayram, Clare; Miller, Graeme; Britt, Helena

doi:10.5694/mja15.00182

Cited by 13 publications

(11 citation statements)

References 19 publications

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“…21 A study that examined the effect of this freeze on GP income found that by 2017-18, based on CPI rises, GPs would be losing 7.1% of the rebate income compared with 2014-15, thus needing to increase their consultation fees to recoup income lost through the freeze. 22 For patients, this would result in a higher out-of-pocket pay for the gap between the consultation fee and the Medicare rebate. There is likely to be similar upward pressure on paediatrician consultation fees.…”

Section: Discussionmentioning

confidence: 99%

Private general paediatric care availability in Melbourne

Kunin¹,

Allen²,

Nicolas³

et al. 2017

Aust. Health Review

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Objective The aims of the present study were to determine the actual availability of private general paediatric appointments in the Melbourne metropolitan region for children with non-urgent chronic illnesses and the cost of such care. Methods A 'secret shopper' method was used. Telephone calls were made to a random sample of 47 private paediatric clinics. A trained research assistant posed as a parent, requesting the first available appointment with a specific paediatrician. Data regarding appointment availability, total potential charges and net charges after the Medicare rebate were collected. Results Appointments were available in 79% (n=37) of clinics, with 72% (n=34) able to offer an appointment with the requested general paediatrician. The number of days until available appointments varied from same day appointments to a wait of 124 days, with an average wait of 33 days. Of practices that provided information about the appointment cost (n=42), five bulk-billed for the consultation, whereas the remainder (n=37) were fee-paying clinics. The potential maximum charge for an initial consultation in the fee-paying clinics ranged from A$177 to A$430, with an average cost of A$279. The potential maximum out-of-pocket cost for patients ranged from A$40 to A$222, with an average out-of-pocket cost of A$128. Conclusions Private paediatric care in the Melbourne metropolitan region is generally available. The out-of-pocket cost of private paediatric out-patient care may present a potential economic barrier for some families. What is known about the topic? In Australia, out-of-pocket expenses for private specialist care are not covered by private health insurance. There are no data available on the actual cost of private paediatric consultations that are based on real-time assessments. Data collected in 1998 suggested that the average waiting time for a first standard consultation with a general paediatrician in a private room was 14.1 days. There are no recent empirical data on appointment availability and waiting time for appointments with general paediatricians in Australia. What does this paper add? There is high availability of paediatric consultations in the private sector. Waiting times for an appointment vary considerably from same day appointments to a wait of 124 days, with an average wait of 33 days. The cost of a private paediatric consultation in Australia to the patient is considerable, with an average potential maximum up-front charge for an initial consultation of A$279 and an average potential maximum out-of-pocket cost of A$128. What are the implications for practitioners? Data on the availability and cost of private paediatric consultations are imperative to formulate evidence-informed policy and better understand variations in the availability of public and private care.

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Section: Discussionmentioning

confidence: 99%

Private general paediatric care availability in Melbourne

Kunin¹,

Allen²,

Nicolas³

et al. 2017

Aust. Health Review

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“…With a final database spanning 18 years and approximately 1.8 million GP–patient encounter records, BEACH data were used to investigate the problems managed by GPs, how GPs managed these problems during consultations, and how the quality of care provided by GPs compared to evidence-based guidelines. BEACH data also identified changes in general practice clinical activity over time [ 22 ] and provided evidence about numerous policy areas, including time spent on patient care not able to be claimed through the MBS [ 23 ], the potential cost of freezing MBS item rebates [ 24 ] and (using length of consultation data) disproved statements that GPs were providing so-called ‘six minute medicine’ [ 25 ]. It was widely recognized that the closure of BEACH created a gap in data available about general practice [ 26 ].…”

Section: History Of General Practice Statistics In Australiamentioning

confidence: 99%

General Practice Statistics in Australia: Pushing a Round Peg into a Square Hole

Gordon

Britt

Miller

et al. 2022

IJERPH

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In Australia, general practice forms a core part of the health system, with general practitioners (GPs) having a gatekeeper role for patients to receive care from other health services. GPs manage the care of patients across their lifespan and have roles in preventive health care, chronic condition management, multimorbidity and population health. Most people in Australia see a GP once in any given year. Draft reforms have been released by the Australian Government that may change the model of general practice currently implemented in Australia. In order to quantify the impact and effectiveness of any implemented reforms in the future, reliable and valid data about general practice clinical activity over time, will be needed. In this context, this commentary outlines the historical and current approaches used to obtain general practice statistics in Australia and highlights the benefits and limitations of these approaches. The role of data generated from GP electronic health record extractions is discussed. A methodology to generate high quality statistics from Australian general practice in the future is presented.

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“…The bottom line is that the removal of the PHI rebate would raise more than $6 billion annually for the public health system. This dwarfs the $749 million projected to be raised from 2014–15 to 2017–18 by a $6 GP co‐payment, 18,19 or from freezing bulk billing rates over that period, 26,27 without denying access to necessary healthcare or having downstream detrimental health outcomes and health system costs. More generally, the opportunity cost to the health system of continuing with the health insurance rebate is enormous.…”

mentioning

confidence: 95%

“…However, despite various GP co‐payments variants having been analysed and rejected in the Australian Senate, the ideological basis and impact of these proposals are still being reflected in Federal Government rhetoric of ‘price and value signals' to reduce bulk billing rates by failing to index for inflation 24,25 . Harrison, Bayram, Miller and Britt 26,27 show with BEACH data that freezing GP Medicare schedule payments from 1 July 2015 would have greater expected impact in reducing GP incomes and their need to charge patients (and reduce bulk billing rates) post 2016–17 than any of the failed patient co‐payment proposals. The impact on the need for GPs to charge by 2017–18 would be almost double that of the $5 patient co‐payment and would increase with every year that GP Medicare payments remained frozen.…”

mentioning

confidence: 99%