The new workforce incentive payment comes just as the government eyes a shake-up to the program.
Rural generalists and GPs can apply now to receive up to $21,000 as part of the new rural advanced skills workforce incentive payment (WIP), even as the Department of Health and Aged Care moves to modernise the system.
The new WIP initiative will recognise doctors working in MM3-7 locations for the additional services they provide in 2023, 2024 and 2025.
While it was originally announced in late 2022, it’s only now – in January 2024 – that the department has started paying up for services delivered in the 2023 calendar year.
There are two streams, one for GPs who do emergency care and one for GPs with extra training in mental health, obstetrics, surgery, anaesthetics or First Nations health.
The incentives under each stream add up to a maximum of $10,500 and doctors can apply for both, creating a theoretical maximum windfall of $21,000.
The minimum payment across both streams is $4000.
Payments are tiered by rurality and levels of service, and doctors can only apply to receive one payment per stream per calendar year, which adds to three payments over the life of the WIP.
This is where calculating a prospective payment gets tricky.
A fact sheet on the program indicated that doctors who worked across locations with different Modified Monash Model classifications would have their hours for a more remote location added to their hours for a less remote location but be paid at the highest level for which they qualify.
In other words, work done in an MM7 region can be added to work done in an MM3 region, but not vice versa.
The example given is that of a GP who provides 17 anaesthetic services in an MM6 location and 14 in an MM4 location.
Their services in the MM6 location only meet the minimum threshold to qualify for the WIP payment, which is counterbalanced by the rural loading applied to the scheme. Calculated this way, the doctor is eligible to receive $9000.
Alternatively, the doctor could choose to count their MM6 services toward the MM4 services, which puts their total number of services up to 31 and bumps them into a higher payment bracket.
But because these 31 services are now all counted as having occurred in MM4, the doctor is only eligible for a $7500 payment.
In this scenario, DoHAC would choose the first method and pay the doctor $9000.
Health Minister Mark Butler called the program a “win-win for doctors and for patients”.
Meanwhile, the RACGP has released its submission to DoHAC’s review of the effectiveness of general practice incentives, which is being run by consulting firm KPMG.
While the college submission was broadly supportive of the current system, emphasising that incentive payment programs are critical to the viability of many clinics, it also argued that they could be better targeted to reward high quality work.
For example, one of the key issues facing the profession right now is the gender pay gap.
Female GPs are often sought out for psychological and women’s health consults.
These consults tend to be more complex and go for longer. Medicare rebates pay less per minute for longer consultations.
As a result, female GPs miss out on around $11 per hour, the RACGP said.
More funding for longer consultations, the college argues, could make a real difference to the pay parity issue.
“The general practice incentives have a significant opportunity to partially offset some of the high-quality complex care required by many patients and to close gender pay gap that fee-for-service Medicare rebates presents,” it said.
Its other suggestions included a “sustained increase in investment” for the program and a reduction in the administrative burden, as well as expanding the program’s repertoire to include four-year-old health checks.