Proposal to give patients more say in what they pay their GPs

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Four in 10 Australians believe that patients should be able to determine how much they pay for a GP visit.

What’s more, patients would be willing to make voluntary out-of-pocket payments of $25 in return for shorter waiting times and longer consultations.

A Monash University study that tested a ‘Patient-Chosen Gap Payment’ (PCGP) model found that 39 per cent of the 1457 Australians surveyed would prefer to set their own out-of-pocket payment than to be bulk-billed or pay the compulsory gap that many GPs currently charge.

The model allowed patients to choose to pay any amount for their GP consultation, from nothing to, potentially, much more than the average out-of-pocket ‘gap’ payment.

In 2018/19, more than 85 per cent of GP visits were bulk-billed and the average gap payment for visits that were not bulk-billed was $38.46.

Monash University Associate Professor Duncan Mortimer said that the proposed scheme does not mean GPs would see patients for free, with the doctor continuing to receive the Medicare rebate for each patient.

“Our results suggest that patient-chosen prices for primary care could generate an extra $1.48bn in revenue, while also incentivising patient-centred care, without the need for complex outcomes-based funding formulas,” Assoc. Prof. Mortimer said.

“This line of research has the potential to reinvigorate debate around the delivery and funding of primary care in Australia, and in other countries with fee-for-service primary care, such as France, New Zealand and the US.

“We hope to undertake further research to understand how GPs would behave under PCGP pricing.

“What we can say is PCGP services are acceptable to patients and may offer a viable alternative pricing model in the market from primary care services.

“However, PCGP services must be delivered at high quality and with careful design if they are to capture market share and increase out-of-pocket contributions.”

While GPs can currently bulk-bill patients and accept the Medicare rebate as full payment for their services, the researchers explain that GP groups have long argued that the rebate is not enough to cover costs.

Research co-author and general practitioner Dr Daniel Epstein believes the PCGP model could provide a happy medium between compulsory out-of-pocket payments and bulk billing.

“Patients’ willingness to make voluntary contributions may come as a surprise,” Dr Epstein said. “Our research found, given the choice, women in more affluent areas were more willing to pay a little extra, while men in disadvantaged areas were more likely to stick with bulk-billed services.”

Researchers say if GPs respond to the PCGP model by taking a more proactive approach to managing their patients’ health, then costs could decrease – helping to limit further increases in private health insurance premiums.

Would you like the opportunity to pay what you wanted for GP services? Would you be willing to pay more for a longer consultation?

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Written by Ben


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