Almost every day we find ourselves deep in discussions with Practice Owners who are asking themselves whether they should change their practice to mixed billing. The issue of bulk billing vs non-bulk billing is complex and there are many factors to consider. As a general rule, practices are fearful that they will lose patients to other practices who are still bulk billing in their area.
Here are some arguments for and against making the switch:
Reasons to Bill:
- This is what GPs are asking for and many of them won’t consider moving to a practice unless they have the chance to privately bill at least 50% of their patients.
- The margins for GP practices have always been very small, but costs have risen considerably as a result of the pandemic and other inflationary pressures. Some consumables have gone up by 50% or more.
- MBS billing rates are not keeping up with costs after Governments of persuasions froze billing rates for several years.
- Many patients have the ability to pay but haven’t ever been pressured to do so. One of our GPs used to get very annoyed with patients who were holding the keys to a top end BMW while refusing to contribute to the cost of seeing a GP.
- GPs now are required to undergo specialist training but earn considerably less than hospital based specialists.
Reasons not to Bill:
- There are many patients who genuinely cannot afford to pay extra for medical services. Imagine being a parent taking two children to the GP and having a consult for themselves. If the standard cost is $82 they are paying out almost $250 and receiving a rebate of $117.
- Bulk billing GPs are amongst the highest earning GPs. This is confirmed with our annual GP salary survey results,but is also born out by anecdotal evidence that GPs who are good at Chronic Disease Management can bill between $600K and $900K without too much difficulty.
- Some GPs prefer to bulk bill as patient expectations are not as high and they can practice in a way that suits them.
- Private paying patients can be more demanding. They may want to get their money’s worth. They may expect to have at least 15 minutes of the doctor’s attention and will want to cover off on a list of issues during a visit.
- It is likely that the practice will lose 10-20% of patients and many GPs report earning less
Having said all of that, we have definitely noticed a strong trend to move away from Bulk Billing by many of our clients. The change has happened rapidly over the last 6 months and given the workforce shortages we only expect the trend to continue. We are hearing daily of practices that are making the change. Every time a practice moves to mixed billing, it makes it much easier for others in the area to follow and this is something we have consistently seen.
To date, we have not had clients report major challenges with the transition. The biggest challenge appears to be getting all the GPs in the practice to agree to the new policy