AGPA Calls for Medicare Independent Pricing Authority

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Media Release

10 October 2024

 

AGPA Calls for Medicare Independent Pricing Authority

The Australian General Practice Alliance (AGPA) today called for a major overhaul of Medicare including the establishment of an independent pricing authority to set the levels of Medicare rebates.

“Medicare is no longer fit for purpose with successive Labor and Coalition Governments starving funding to the point where primary healthcare for Australians is seriously jeopardized” said Dr Mukesh Haikerwal, Deputy Chair of the AGPA when commenting on the landmark RACGP Health of the Nation 2024 Report.

“With over 7000 General Practices in Australia, over 75% of them report that their major concerns are rising business costs, declining business profitability and sourcing and retaining GPs. All of these are directly related to underfunding of Medicare commencing with the Labor and Coalition freezes on rebate increases under the Gillard / Rudd/ Abbot and Turnbull Governments, and below medical inflation increases to an already depleted rebate under the Morrison and current Albanese Governments” he said.

“Practices are generally small privately owned businesses and their viability is a critical part of our entire healthcare system, providing the essential support services where Australians can see a GP, nurses and other health professionals. The proportion of patients delaying or not accessing healthcare has doubled as rising costs and underfunding of rebates have forced GPs into private billing. This raises the red-flag of worse outcomes as early diagnosis and treatment brings better results for patients”

“When Medicare was first introduced the promise was access to affordable universal health care and the rebate was 85% of the “schedule fee” which was close to the actual cost of providing services. The “schedule fee” has been eroded in value and the rebate for Australian Citizens towards their health care costs has been gutted and is now closer to 45%. The costs of providing services sees over 35% of GPs forced to charge over $90 for a consultation. One third of GPs are planning to cease practicing in the next five years, many are reducing hours available and the specialty is not attracting enough graduates to replace them”.

“All of these factors indicate the disaster facing Australians being able to access the excellent GP-led care they are used to and deserve – amongst the best performing health systems in the world. Using other workers to perform single tasks fragments care and near enough is not good enough for our health. Today’s holistic care takes intense life-long learning and skill” Dr Haikerwal said.

“While there are also other factors such as the compliance and regulatory burden, the single factor having the greatest impact is inadequate funding”.

“Successive governments have shown that they cannot be trusted with funding the primary healthcare of Australians.  There needs to be an innovative approach, with ambition to improve the system, consistency and long-term systemic thinking.  It is now time to commence major reforms – starting with an independent pricing authority to set appropriate levels for the Medicare rebate”, Dr Haikerwal said.

Ends

Media Contacts:

Dr Mukesh Haikerwal, Deputy Chair AGPA, 0407 599 332

AGPA Secretariat 02 6290 1505

The Australian GP Alliance (AGPA) represents the interests of GP Practice Owners, addressing issues faced by Principal-led General Practices.

The Australian model of GP owned private general practice has been responsible for our international reputation as an efficient and highly effective primary health care service.

The continuation of high quality primary healthcare in Australia is dependent on the continued viability of the Practices that provide the leadership and infrastructure that allows GPs to practice, and patients to access the healthcare system.

Download media release here

 

ACT Election 2024 – AGPA Welcomes ACT Liberals Commitment to General Practice

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Media Release 24 September 2024

AGPA Welcomes ACT Liberals Commitment to General Practice

The Australian General Practice Alliance (AGPA) today welcomed the Canberra Liberals election commitments to increase numbers of GPs in the ACT and their re-commitment to exempt payments made to GPs from payroll tax.

The ACT Liberals today announced policies to pay up to $100,000 of HECS debt for up to 30 new GPs in return for a 5-year commitment to practicing in the ACT, to boost funding for a research chair for General Practice with the ANU Medical School, and to exempt GP payments from payroll tax.

“These are very sensible policies” said Dr John Deery, Chair Australian GP Alliance and Canberra Practice Owner. “We know that one dollar spent in primary health care saves ten dollars of hospital care. These policies have the potential to boost numbers of GPs in Canberra in both the short-term and the longer-term” he said. “Increased numbers of GPs will improve the access to health care for patients. This investment in numbers of GPs will pay dividends for the ACT Government by helping to keep patients out of hospitals. ”

“Exempting GP payments from payroll tax will help to keep costs down for patients. We already have major Practices in the ACT increasing patient charges in anticipation of having to pay this tax, and GPs leaving the ACT for jurisdictions which have taken a more sensible approach. “

Dr Deery said “Two major drivers preventing patients accessing high quality primary healthcare are the numbers of GPs and the cost of patient visit. The GP payroll tax is the imposition of an existing tax which has not been imposed previously. It is less than 12 months old and we already seeing the evidence of its negative impacts on both GP numbers and patient costs”

“The provision of legislative reforms and training to allow GPs to diagnose and prescribe for ADHD is a much needed reform, increasing the quality of services from General Practice and reducing pressures on other parts of the health care system”.

“We commend the ACT Liberals for their commitment to General Practice “ Dr Deery said.

Ends

 

The Australian GP Alliance (AGPA) represents the interests of GP Practice Owners, addressing issues faced by Principal-led General Practices.

The Australian model of GP owned private general practice has been responsible for our international reputation as an efficient and highly effective primary health care service.

The continuation of high quality primary healthcare in Australia is dependent on the continued viability of the Practices that provide the leadership and infrastructure that allows GPs to practice, and patients to access the healthcare system.

For media inquiries or further information, please contact:

AGPA Secretariat 02 6290 1505

AGPA Media Release

ACT Liberal Media Release

AGPA Position Statement on Potential Government Funding Cuts for Chronic Disease Management

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The Australian GP Alliance represents doctor-owned general practices across Australia, and we must express our profound concern and frustration regarding the recent announcement of funding changes for chronic disease management item numbers, effective from November 1st, 2024. This decision, coupled with the lack of timely communication and certainty, is not only imprudent but also detrimental to the healthcare system and the patients we serve.

Impact on Patient Care

Chronic disease management is a cornerstone of primary healthcare, providing essential support to patients with long-term conditions. These services are meticulously planned and booked months in advance to ensure continuity of care. The abrupt reduction in funding, without adequate notice or detailed information on the new rebates, jeopardizes the quality of care that our patients rely on. This uncertainty is causing significant distress among general practitioners and their patients, who are left in limbo regarding their ongoing treatment plans.

Economic and Health Consequences

Australia is currently facing an epidemic of chronic illnesses, which are leading causes of poor health, disability, and premature death1. Reducing funding for chronic disease management at a time when the burden of these conditions is escalating is counterproductive. It undermines the efforts of GPs who are at the frontline, managing these complex conditions and preventing hospital admissions. The financial strain on patients, particularly those in rural and remote areas, will likely increase, exacerbating health inequities and placing additional pressure on an already overburdened healthcare system.

Call for Immediate Action

We urgently call on the Federal Government to reconsider this decision and provide immediate clarity on the new funding arrangements. It is imperative that any reforms to the Medicare Benefits Schedule (MBS) do not result in a net reduction of funding for chronic disease management. We also request a delay in the implementation of these changes to allow general practices sufficient time to adjust and plan accordingly.

Conclusion

The health and well-being of millions of Australians depend on the stability and adequacy of funding for chronic disease management. We urge the government to engage in meaningful consultation with healthcare providers and stakeholders to ensure that any changes to the MBS support, rather than hinder, the delivery of high-quality, patient-centered care.

MBS Comparison

2024 RACGP President Candidate Responses to AGPA Questions

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There are five candidates for RACGP president in 2024. They are:

Dr Palmyra De Banks, Dr Alan Bradley, Dr Michael Clements, Dr Monirul Haque & Dr Michael Wright.

The Australian GP Alliance put four questions relevant to Practice Owners to the candidates requesting written responses from them.

  1. Do you understand the costs involved in running a Practice?  Responses are here
  2. Do you think you can provide a vision for the future for General Practice if you don’t have experience in running a small business? Responses are here
  3. What is your plan to improve the viability of General Practices? Responses are here
  4. What is your plan to help prospective Practice owners? Responses are here

The Australian model of GP owned private general practice has been responsible for our international reputation as an efficient and highly effective primary health care service. The continuation of high quality primary healthcare in Australia is dependent on the continued viability of the Practices that provide the leadership and infrastructure that allows GPs to practice, and patients to access the healthcare system.

AGPA Question 4:What is your plan to help prospective Practice owners?

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Dr Palmyra De Banks:
Supporting prospective practice owners is crucial for the future of general practice. I plan to advocate for more accessible and practical business support and training for GPs, ensuring they are well-equipped to manage the financial and operational aspects of a practice. Additionally, I will promote mentorship programs that connect new practice owners with experienced operators who can provide guidance and support. My own experience in setting up clinics and managing a large network of practices has shown me the value of such support. I will also push for financial incentives and grants to assist in establishing practices, particularly in underserved areas.

Dr Alan Bradley:
I teach hundreds of GP registrars in my role as a medical educator. The majority aren’t interested in becoming practice owners. This needs to change, unless we want a GP landscape dominated even further by large multinational corporations.
We do that by listening and responding to the concerns of current practice owners, as well as by improving the viability of General Practice as a profession. As above: this involves not capitulating to scope creep, avoiding going down the NHS capitation path, and increasing the respect and attractiveness of general practice by achieving pay parity for GP registrars with their hospital colleagues.

Dr Michael Clements:
Firstly, it is by fiercely defending and advocating for the models of small business general practices in Parliament and pushing back on some of the narratives of the idea that GP system has ‘failed’ – it hasn’t failed it just hasn’t been funded. I have been a big fan and regular attender and presenter at the RACGP Practice Owners conferences, I feel like it is my tribe. These conferences have so much energy and the enthusiasm from potential practice owners is palpable so I think we need to extend that support and that energy through other aspects of RACGP work. We need a culture and a community of support throughout the entire college for practice ownership and owners.

Dr Monirul Haque:
Share the knowledge and support each other on overcoming the barriers. I would support the prospective Practice owners by organising a Practice Owner Mentor and share best practices.

Dr Michael Wright:
Through my work with the RACGP Expert Committee and with Avant, I’ve been providing active support for prospective owners in setting up practices, and presented at multiple RACGP and Practice Owners conferences about practice financing and viability issues. This promotion will continue under my Presidency. I think the main attractor to encouraging interest in practice ownership  will come through better evidence of financial viability (I’m currently leading a research project out of UNSW that is looking at this), and a stronger narrative about general practice being a great profession and having a strong future.  The real evidence of success will come from increased interest in practice ownership (reported in Health and the Nation and in member sentiment).  I look forward to working with AGPA members to achieve this plan.

AGPA Question 3: What is your plan to improve the viability of General Practices?

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Dr Palmyra De Banks:
Improving the viability of general practices requires a multifaceted approach. My plan includes advocating for significant increases in MBS rebates, including increased item numbers scope, to better reflect the true cost of care; addressing workforce shortages by promoting general practice as a rewarding career; and reducing the administrative burdens that take time away from patient care. My experience in managing a large network of clinics gives me a practical understanding of the challenges faced by practice owners, and I am committed to working closely with them to develop and implement strategies that enhance financial sustainability and ensure the long-term viability of general practices.

Dr Alan Bradley:
My plan involves strident advocacy about the upcoming Scope of Practice Review, of avoiding the slide into capitation via MyMedicare and blended funding models, and of ensuring that no doctor who decides to train as a GP is required to take a pay cut and lose their entitlements to do so. For more, please see my website: https://www.dralanbradley.com.au/racgp-presidential-candidate-2024

Dr Michael Clements:
We need to protect fee for service and private fee setting as a core component of our primary care model and support our practices and members breaking free from the Medicare tether whenever possible. At the same time we need to acknowledge some practices and practitioners will want to engage with the government funding models, particularly for vulnerable communities and use blended payment models and bulk-billing, so we also need to advocate for increased rebates, increased overall funding and bundled payments that are actually workable within a small business. We must also push to reduce red tape and time consuming madness such as the authority line.

Dr Monirul Haque:
I have few ideas. Firstly by including the Family Medicine with General Practice,  it will increase the scope of work we GPs do. Secondly to address the shortage of Doctors, I would work towards for creating opportunity for the overseas trained doctors to get trained in the metropolitan cities for the first two years before going in the rural areas. Thirdly, work towards increasing the Medicare rebate for chronic, complex and challenging medical problems. Fourth- more fund for GP registrar and supervisors equivalent to hospital registrars and supervisors.

Dr Michael Wright:
My platform outlines a series of measures to increase funding for general practice including 1) targeted MBS funding  increases for high needs patient and the GPs looking after them, 2) increasing WIP and removing WIP caps and more capacity payments to support practice strengthening in areas such as care coordination and governance, 3) regulatory changes to allow practice team time to be included within consultation time.  I will also commit to strong and successful advocacy in funding and workforce reform as the key accountability for my term as President. I will also share a more positive narrative about the potential of general practice, a push for us to expand our scope and use technology to improve our standing, financial viability and capacity to lead the health system

AGPA Question 2: Do you think you can provide a vision for the future for General Practice if you don’t have experience in running a small business?

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Dr Palmyra De Banks:
I have significant experience in both clinical practice and business management, having established clinics in the UK and currently overseeing a large network of 19 clinics in Victoria and 80 clinics nationally. This extensive background equips me with a unique perspective on the challenges and opportunities within general practice. My vision for the future is informed by this experience and focuses on creating a sustainable, patient-centred model of care that supports both practitioners and patients. I am committed to leveraging my experience to advocate for policies that benefit the entire general practice community.

Dr Alan Bradley:
I have experience running a small business – I ran a successful tutoring company while working as a resident doctor. However, I think a vision of the future of General Practice is much broader than the experience of small business owners. That’s why I think having more representation on the RACGP board – of GPs who are not practice owners – will improve discussion at board meetings and lead to overall better outcomes for General Practice in Australia.

Dr Michael Clements:
I joined RACGP and AMA Councils at the same time I opened my practice as I wanted more business intelligence on understanding how I needed to shape my business to evolving challenges. I moved up the chain within RACGP and want the top job now as I believe we need a practice owner who truly understands the implications of government policy on general practice at the coalface. My vision is for profitable and sustainable private practices to be the core providers of health care in the country and I know practice owners are ready to deliver with the right support.

Dr Monirul Haque:

I do believe, running a small business is important to understand the complexity of running a General Practice. Only then one can understand the pain points of the Fellow General Practice owners and help them with growing their business.

Dr Michael Wright:
Not impossible but experience in owning and running a practice has given me many skills which are still of value in my current practice where although I am an independent contractor all of our contractor GPs are keenly aware of viability issues.  My experiences as an owner, salaried and contractor gives me multiple perspectives to draw on.

AGPA Question 1: Do you understand the costs involved in running a Practice?

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Dr Palmyra De Banks :
Yes, I have a deep understanding of the costs and complexities involved in running a practice. Before emigrating to Australia, I was a owner and partner in a GP practice and set up my own clinic in the UK, where I learned firsthand about the financial, staffing, and operational challenges. Today, I directly oversee 19 clinics in Victoria and 80 clinics nationally, providing me with a broad and current perspective on the financial realities facing general practices. This experience allows me to appreciate the delicate balance required to maintain high standards of care while ensuring financial sustainability.

Dr Alan Bradley:
I do. Fortunately, even if I did not, the majority of the RACGP board are practice owners. Rest assured: the costs of running a practice will be well understood at RACGP Board meetings regardless of which candidate AGPA members vote for.

Dr Michael Clements :
I opened my first practice in 2015 in Townsville and I am now about to open my 5th in Charters Towers. I have been almost ruined by flood, struggled my way through Covid and I am now on the other side with a thriving number of practices and rural/remote outreach clinics, RACF and school clinics.  I have been kept awake at times wondering how to pay the staff and at times have been ready to give it all away but I am now very proud to have over 50 staff and doctors working with me on our vision. Owning practices is a core part of my identity as a meaningful contribution to my community.

Dr Monirul Haque:
As a practice owner myself, I do understand the cost and challenges of running a general practice business.

Dr Michael Wright:
I’m very aware of the costs in setting up and running a practice.  I was a practice owner for nearly a decade with my father in Queensland, before moving to and working in the UK as a contractor and salaried doctor, and then moving back to Australia.  In my role with RACGP as Chair of RACGP’s Reference Expert Committee for Funding and Health System Reform for nearly six years, I’ve collaborated with many practice owners and championed our Business Sustainability Focus, led the development of  the private billing toolkit, billing calculators and tools for GPs in setting up a private practice.  With additional education and training in health economics, I’m keenly aware of the economics of general practice and the need to create incentives for GPs and practice owners. I’ve also led the Health of the Nation survey to prioritise financial viability as a core focus.

Medicare – Op Ed by Crispin Hull

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Medicare

OpEd for 30 July 2024

By Crispin Hull

Medicare is in urgent need of some CPR. Not just the pulmonary and cardio, but a resuscitation of every part of the human body and the medical procedures that can be applied to it.

The death by a thousand cuts of Australia’s once proud universal free medical insurance scheme continued unabated this month.

The annual inflation adjustment applied to the schedule of fees was set at 3.5 per cent – once again below the real rate. And it was not applied to all items.

Read more

AGPA Webinar – Fraud and Theft Prevention

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AGPA Webinar

Fraud & Theft Prevention

Thursday 22 August 2024, 7:30pm AEST

7:00 pm SA, 5:30 pm WA

 

Speakers

Loryn Einstein – Medical Billing Experts

Gavin Andrews – Port Melbourne Medical  

 Fraud and theft is a risk for any business and GP Practices with large numbers of daily transactions are as vulnerable as any. The consequences for ruined lives, financial and reputational loss and the destruction of trust and teamwork are expensive and time consuming. There are typical causes and symptoms that can be identified and business practices that can be adopted to reduce risk.

The speakers have extensive experience in fraud prevention and investigation.

This is a rare opportunity to become better informed on the typical vulnerabilities of GP Practices and the business processes and practices that can be adopted to prevent fraud and protect your Practice.

Book at

https://www.trybooking.com/CTWOD

This event will be free

to AGPA members.

AGPA non Members $50