Bulk billing rates plunge and gap fees surge across the state’s GP clinics

An independent report shows major problems with SA’s GP clinics with the state experiencing the fastest rising Medicare gap fees across the country.

Bulk billing rates are in free fall as the federal government looks to health as its election saviour.

Figures from independent online health care directory Cleanbill.com.au show bulk billing rates in South Australian GP clinics plummeted to just 7.4 per cent in January, down from 24.2 per cent two years earlier.

Nationally the figure bombed from 35 per cent to 20 per cent over two years.

Cleanbill directly contacted every clinic it could find to check their billing, a total of 6925 clinics – based on a standard adult consultation during weekdays.

The federal government uses a different protocol to measure bulk billing, as many clinics have a mix of billing and will bulk bill pensioners, welfare recipients and children but may charge a gap for working adults.

Founder of independent online health care directory Cleanbill, James Gillespie. Picture: Supplied

Cleanbill’s third annual Blue Report released today also shows SA experienced the single largest increase in out-of-pocket costs of any state in 2024.

SA adults who cannot find a bulk billing GP now are paying an average of $41.61 for a standard consult, compared to $35.89 two years ago.

The good news is this was still the lowest average gap fee in the nation.

Nationally the average gap fee was $43.38 led by Tas at $54.26, the ACT at $51.84, NSW at $44.05, NT at $43.86, Qld at $43.33, WA at $42.66, Vic at $42.01 and SA at $41.61.

Cleanbill founder James Gillespie is sending the findings to every federal, state and territory politician.

Bulk billing rates in South Australian GP clinics plummeted to just 7.4 per cent. Picture: File/Generic

“This is a groundbreaking report,” he said. “It’s the first ever year-by-year analysis of what GP clinics are charging their patients on a national scale and its implications for the state of Australian healthcare are significant.

“The trends it outlines paint a concerning picture for healthcare accessibility in Australia.

“While the decline in bulk billing has slowed, rates have continued to slide, with almost 80 per cent of available Australian GP clinics no longer offering bulk billing to adult patients.

“In these circumstances, it’s easy to see why over 1.5 million Australians didn’t go to see a GP in 2023-24 because of concerns surrounding cost; up 25 per cent from 2022-23.

“This should not be happening.”

Research by polling company Redbridge shows more than one third of people have delayed medical treatment due to economic conditions.

The report comes amid commentary the government is set to pour money into health as an election vote winner while reigniting past “Mediscare” claims the Coalition will downgrade the universal health insurance scheme.

State by state, Cleanbill’s report found the bulk billing rate was 34 per cent in 2377 clinics surveyed in NSW, 19 per cent in 1796 clinics in Vic, 14 per cent in 1373 clinics Qld, 6 per cent in 661 clinics in WA 7.4 per cent in 448 clinics in SA, 0 per cent in 128 clinics in Tas, 3 per cent in 98 clinics in the ACT and 9.5 per cent in 44 clinics in the NT.

Originally published as Bulk billing rates plunge and gap fees surge across the state’s GP clinics