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

2. 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

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

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

5. Trends in practice organisation
Source: MABEL Survey

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

7. Percent of GPs who are Principals
Source: MABEL Survey

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

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

10. 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

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

12. Job satisfaction and work-life balance
Source: MABEL Survey

13. Percent very satisfied by age
Source: MABEL Survey

14. 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?