Don’t turn your nose up at the triple BBI

3 minute read

The move is already changing behaviour and will pay off in two ways, says the head of one of Australia’s biggest GP corporates.

It’s been just over a month since the bulk billing incentive payment was tripled and it seems to be making a difference, despite murmurs of discontent from the industry. 

Andrew Cohen, CEO of GP clinic chain ForHealth, told The Medical Republic that the bulk billing rates at 20 of the corporate’s lowest-bulk billing practices had swung up by around 5% in just three weeks.  

“When the government made the changes, a lot of people talked about potentially not changing their billing practices,” he said. 

“That should be the minority of GPs, because from an economic point of view it makes very little sense for someone not to bulk bill a healthcare card holder.” 

Mr Cohen said he had recently met with the owner of another large GP corporate who had also noted a 5% upswing in bulk billing.  

While the $20 payment – up from around $6 – for bulk billing a Level B is surely welcome, the actual cash is not the biggest drawcard for Mr Cohen.   

“[A lot of] GPs are thinking about the gap part – like, if they’re charging a $30 gap and [bulk billing with the incentive] is equivalent to a $20 gap, they’ve gone ‘I’m not going to do it’,” he said. 

“But they’re not thinking about the elasticity [of demand], and that’s really, really significant.” 

ForHealth surveyed a sample of 1000 healthcare card holders and around 50% said they would find a new GP clinic if they were charged out of pocket even once. 

The people who would stay with the clinic said they would likely change their behaviour and come in far less frequently.  

If a healthcare card-holding pensioner, for example, went from visiting their GP seven times a year to just three it would not only impact the clinic’s bottom line, but their health would likely decline.  

“From a net economic point of view, in almost all cases the GP is better off bulk billing healthcare card holders because they will see them more often and they’ll see more of them,” Mr Cohen said.  

“It’s only in very affluent areas with gap fees that are well above $30 – probably a gap fee of $50 plus – where the economics would be different.” 

In Mr Cohen’s experience, GPs also enjoy “doing the right thing” by healthcare card holders in general.  

At the end of the day, he said, tripling the bulk billing incentive was the biggest investment in Medicare since its inception.  

“We should be celebrating that investment and celebrating the fact that, from an economic point of view, 90% of doctors are better off bulk billing healthcare card holders,” the GP corporate boss said.  

“And I think that that’s a great social good.” 

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