The department anticipates lower-than-expected rates of Australians accessing Medicare as scope of practice changes take effect.
The Department of Health, Disability and Ageing’s 2026-27 corporate plan lowers its target for the percentage of Australians who claim an MBS item for a GP consult, citing an increase in non-MBS pharmacist-led services and online-only providers.
Published last week, the corporate plan set out measurable objectives for the department in the current financial year (2026-27).
A corresponding audit report would be published by the Department of Finance at the end of the following calendar year.
While the corporate plans for 2025-26 and 2026-27 were available, the most recent audit report only covered the 2024-25 financial year; this meant that we did not yet know how the department fared in meeting its goals last year, let alone how it was tracking for the year to come.
But there were still clues to be found by comparing the 2025-26 document and the 2026-27 document.
For instance, the objectives for both performance measures 2.1A and 2.1B – the percentage of Australians who accessed an MBS service and the percentage of Australians who had a GP non-referred attendance item claimed through the MBS, respectively – were both revised downwards.
Both of these were effectively measures of the number of people coming through the Medicare system, but not necessarily reflective of how doctors were billing.
Under the 2025-26 plan, the goal was for >90% of the population to have accessed an MBS service; any result between 87% and 90% was considered “substantially achieved” and a result of less than 87% was considered “not achieved”.
But under the 2026-27 plan, 87% was the objective.
The same was true for the GP-specific access goal.
In the 2025-26 plan, the goal was for 85% of the population to have claimed an MBS rebate for a GP consult, and anything less than 82% meant the goal was “not achieved”.
But in the 2026-27 plan, the goal was lowered to 80%, and the not-achieved threshold was changed to 78% or less.
Related
In both cases, the department said targets were “adjusted to reflect the expected reduction in demand”.
“Reductions in demand for services may result from patients accessing care through other health professionals (e.g. obtaining clinical certificates for work absences from pharmacists or accessing clinical services through pharmacy-led trials in some states),” DoHDA said of the GP-specific access measure adjustment.
“Additionally, services not funded under the MBS may be accessed through privately funded providers (e.g. online clinics), or through other government programs (e.g. Department of Veterans’ Affairs).
“Reductions in demand for Medicare services due to these factors would be anticipated to increase in the future, based on current trends.”
In short, it appeared that DoHDA anticipated a dip in the total number of Australians visiting the GP.
Intriguingly, though, the target for the GP non-referred bulk billing rate – which had less to do with the proportion of the population who were accessing the GP and more to do with the billing behaviours of GPs – increased between the 2025-26 and 2026-27 corporate plans.
For the 2025-26 year, the target was 78.5%. For the 2026-27 year, the target was 80.8%.
This wasn’t strictly comparable to the change in targets for the access measures. Rather than setting a specific target percentage bulk billing rate, DoHDA took the year-to-date bulk billing rate from earlier in the calendar year and added an amount to it.
In 2025-26, it added 1%; in 2026-27, it added 0.5%.
DoHDA did not give any additional comment as to why it added 0.5% this year instead of 1%, other than to say it was “based on last year’s trend”.
From this, one could interpret that the government anticipated the bulk billing rate to continue on its upward trajectory, if potentially at a slower pace.
Other GP-relevant changes included the measure of Primary Health Network efficacy.
Until this year, the measure of PHN success had been whether they met delivery objectives for national programs.
Under the new plan, the measure was whether PHNs were meeting delivery objectives in supporting general practice.
The department selected three PHNs for “case study analysis” to be conducted in 2026-27. These were: Murray PHN, North Western Melbourne PHN, and North Sydney PHN.
