A Health Check for General Practice ANZ - Melbourne Institute Health Sector Report General Practice Trends Professor Anthony Scott, The University of Melbourne

Policy context Continuing funding pressure Value-based health care Medicare fee freeze, then slow thaw, and (failed) GP copayment Moving away from fee-for-service Health Care Homes Practice Incentive Program and quality improvement Value-based health care Pressure of increased supply and competition

Proportion of women by age (2015) Source: MDA (AMPCo)

Growth in the number (FSE) of overseas trained GPs Source: Medicare

Trends in practice organisation Source: MABEL Survey

Growth in the number of staff per practice Source: MABEL Survey

Percent of GPs who are Principals Source: MABEL Survey

Median hourly earnings (real terms) – GPs vs specialists Source: MABEL Survey

Medicare revenue and hourly earnings (adjusted for CPI) Source: Medicare; MABEL Survey

Have bulk-billing rates fallen and prices increased? Jury is still out Medicare data show continuing rises in bulk-billing Out of pockets increasing, but have been doing at the same rate as before the fee freeze Is competition keeping prices low? But Medicare data does not show important sub-groups Medicare data does not show the proportion of patients bulk-billed (only visits) Anecdotal data, and Primary Health new non-bulk-billing business

Proportion of patients bulk-billed Medicare fee freeze Source: MABEL Survey

Job satisfaction and work-life balance Source: MABEL Survey

Percent very satisfied by age Source: MABEL Survey

Summary Significant changes in structure and organisation of the sector Medicare revenues falling but GP hourly earnings increasing Job satisfaction and work-life balance beginning to fall We do not know if these changes are influencing patient’s health status, quality of care provided, or access to care Key issue: How do we improve health outcomes and access to care for patients while supporting an efficient and healthy general practice sector?