Medicare Package released
28th April 2003

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Here is a brief outline of the key components of the Medicare package announced today by the Prime Minister John Howard and the Minister for Health & Ageing, Senator Kay Patterson.  ADGP will continue to analyse the contents of the package and provide further information and comment over the week.  Please do not hesitate to contact the ADGP office if you have any questions.

Brief Outline of Key elements of Medicare changes

NB Both the GP Access and Safety Net components require legislative change and will need to be passed by both houses of Parliament before they can be implemented.

1. "GP Access Scheme"

Voluntary; open to all general practices (accredited and non-accredited practices, VR and non-VR GPs), including Aboriginal Medical Services.

Covers all "in-surgery" services, as well as after hours, home visits and aged care facility visits, but not in-hospital procedural services.

Commences November 2003 - practices that wish to opt in will need to register.

Opt-in practices will be advertised to the public via a 1-800 number and the Department of Health & Ageing website.

All GPs must agree for the practice to opt-in - this may have implications for employee/principal, associateship/partnership arrangements in practices.

Incentives per bulk billed service to concessional card holder:
RRMA 1 $1.00 (annual total per FTE GP with average concessional workload $3,500 - practices with higher than average number of concessional patients may expect higher incentive payments)

RRMA 2 $2.95 (annual total $10,250)
RRMA 3-5 $5.30 (annual total $18,500)
RRMA 6-7 $6.30 (annual total $22,050)

Incentives will be paid as monthly cash payments by the HIC to the practice (not to individual GPs), based on the number of bulk billed services to card holders and listed by GP provider number.

One-off incentive for opt-in practices to support connection to HIC Online ($750 metro, $1,000 rural), including broadband access for rural/remote practices, with 2 day turnaround of payments promised and reduced paperwork.  Available February 2004.

There are no incentives for practices to bulk bill non-card holders.

Up-front costs for non-card holders may be less on a per-consultation basis, but if GPs increase fees, overall affordability will be reduced.

Non-card holders can opt to buy private health insurance to cover gap payments (the difference between the rebate and the amount charged by the doctor) over $1,000 (per family) at a cost of around $50+ per year.

The package offers convenience for patients (non-card holders of opt-in practices only) of reducing visits to Medicare offices but general practices will be dealing with the administration instead.

The package offers "advice and support [to practices] on improved scheduling and other business practices" which implies a role for Divisions of General Practice, but no funding has been identified for this function.  ADGP is continuing to negotiate with the government on this.

2. "Safety Net"

Government will reimburse 80% of total out of pocket non-hospital medical costs (including any costs over the schedule fee) over $500 per concessional family or individual per annum.  Registration with HIC is required to receive this.

Commences January 2004.

3.  "Veterans"

$3.00 additional fee paid for each LMO consultation to Gold or White Card holders.

4. "Workforce"

234 additional medical school places per year starting 2004 - doctor will be bonded to areas of workforce shortage for a minimum of six years after completion of training - does not specifically state that doctor must work in general practice.

Allocation of places across universities to be "determined by Minister for Health and Ageing in consultation with Minister for Education Science and Training".

150 additional GP registrar places per year to commence in 2004 in areas of workforce shortage - this has implications for Divisions to support an increase of accredited training practices.

Extension of practice nurse initiative to outer metropolitan areas from November 2003: 457 FTE practice nurse places for 800 general practices in areas of workforce shortage, with the option to choose to employ allied health professionals instead.  Only practices that opt in to the GP Access Scheme will be eligible.