Revitalising Revenue: How to Navigate New Budget Changes and Forecast Your General Practice’s Future Billings

Hello, dedicated health professionals! The air is thick with anticipation as we delve into the recent budget changes that could reinvigorate your General Practice’s billing. There’s much to unpack, and we’re eager to help you navigate these changes effectively.

A New Horizon: Level E Consults

Firstly, let’s talk about the introduction of Level E consults. This new category offers an opportunity for consultations exceeding 60 minutes, with a rebate of around $184. This new category is a billings increase compared to the current Level D amount of $113.30.

To gauge the impact on your practice, consider the number of consultations that frequently exceed 60 minutes. Are there any patterns, specific demographics, or conditions often requiring extended consultations? To forecast the impact of the new Level E consults, run a report in your practice management system for the total number of consults exceeding 60 minutes and the billings for those consults. Then, multiply that number of consults by the newly proposed incentive and compare the two figures.

We unpacked the financial impact of the introduction of Level E consults and found that, on average, a practice would have 16 consults per month that are currently billed at a Level D but go over 60+ minutes. This saw a billing impact on average per practice of $1,056 per month.

Exploring Rebate Increases: Levels A to D

Next, we have some good news for the bread-and-butter consultations – Levels A, B, C, and D. These consultation levels have all seen an increase in rebates. Let’s break down the changes:

  • Level A consult Item 3 (short consult): $18.20 to $18.95
  • Level B consult (up to 20 minutes) has increased from $39.75 to $41.40
  • Level C consult (20 minutes to 40 minutes) from $76.95 to $80.10
  • Level D consult (40 minutes to 60 minutes) from $113.30 to $118.00

That’s an increase of 4% for standard consults. Take a moment to review your practice’s consultation mix. With the new rebates in mind, you can forecast the potential revenue increase for these core consultation levels.

Tripled Bulk Billing Incentives: 10990 & 10991 and MMM items

The budget also impacts patients aged 15 and under, pensioners, and concession card holders. The bulk billing incentives for the 10990 & 10991 and relevant Modified Monash Model (MMM) items have been tripled, a change that could significantly impact practices that serve many of these patients.

The incentive amount varies depending on the practice’s location, as per the “Modified Monash Model” system. Here’s a quick rundown:

  • MMM1 (metropolitan): $6.60 to $20.65
  • MMM2 (e.g., Launceston, Tas): $10.05 to $31.40
  • MMM3 (e.g., Cessnock, NSW): $10.65 to $33.35
  • MMM4 (e.g., Port Augusta, SA): $10.65 to $33.35
  • MMM5 (e.g., Renmark, SA) : $11.35 to $35.40
  • MMM6 (e.g., Lightning Ridge, NSW): $11.95 to $37.40
  • MMM7 (e.g., Thursday Island, Qld): $12.70 to $39.65

The higher bulk-billing incentives represent a considerable boost to practice revenue, especially for those practices with a high percentage of patients who fall into these categories. That is if the practice bulk bills and the new incentive amount is higher than your current private gap fee charged to patients.

Look at your patient demographics and note the prevalence of these groups. This assessment will give you a sense of the potential uplift in your bulk billing revenue. If you are a mixed billing practice, you will want to compare this increased billing item to your average private fee charged to those eligibility groups.

We’ve created a spreadsheet where you can enter you number of items billed and it will automatically calculate the billing difference. If you’re already using Cubiko we’ve brought out a new metric that measures this for you.

Looking Ahead

Considering these changes, it’s time to put pen to paper (or fingers to keyboard) and start forecasting. Here’s how you can get started:

  1. Understand the Changes: Knowledge is power. Take the time to understand what these changes mean for your practice fully. How will this change how your team works and how you deliver patient care? What kind of patient experience are you aiming to deliver?
  2. Analyse Your Data: Look at your patient demographics, consultation mix, and other relevant data. This will give you a clear understanding of where these changes will impact your practice the most.
  3. Forecast Conservatively: While seeing potential revenue increases is exciting, forecasting conservatively is prudent. This approach ensures you’re taking advantage of the impact.
  4. Plan and Adapt: Once you’ve forecasted the potential changes, it’s time to create a plan of action. Consider adapting your practice to maximise these changes and better serve your patients.
  5. Monitor and Review: Regularly review your practice’s financial performance to ensure you’re on track with your forecast. This will enable you to identify any discrepancies and make adjustments as needed.
  6. Engage Your Team: Share these changes and your plans with your team, including GPs, nurses, receptionists, and other staff members. Open communication will help ensure a smooth transition and encourage everyone to work together to maximise the benefits of these changes.
  7. Embrace Continuous Improvement: The healthcare landscape is ever-evolving, and it’s essential to remain open to new ideas and improvements. Keep learning and refining your processes to ensure your practice remains agile and adaptable.

Wrapping It Up

The recent budget changes present exciting opportunities for General Practices, particularly regarding revenue and patient care. Understanding these changes, analysing your data, and creating a solid forecast can pave the way for your practice’s brighter, more prosperous future.

Remember, we’re all in this together. So, let’s work as a team and leverage these changes to create a more sustainable and successful General Practice landscape for all.

Do you have any questions about these changes or ideas on maximising their impact on your practice? Reach out to the team at [email protected] and let us know.

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