In a second I'll get into the modelling itself, but first I wanted to spend just a moment talking about the data that supports the modelling. The department has access to very detailed data about every MBS claim.
This includes information on the patient, such as their concessional status, and many other things, and about the service itself, whether it was bulk billed or privately billed, and if it was privately billed, how much a patient was charged, how much they received in MBS benefits and their residual out-of-pocket costs.
We are also able to attribute claims to GPs to general practices where that practice participates in the Practice Incentive Program (PIP program).
This allows us to build an income model for over 6,600 general practices in Australia, and that's what we've done here. This particular example is of a mixed billing practice in the metropolitan area. In the 2025 calendar year, this practice bulk billed just over 75% of its services and received $670,000 in MBS benefits for those services. It received an additional $260,000 in bulk billed incentives for services that were bulk billed to children under the age of 16 and concession card holders.
This practice privately billed 25% of its services. In total, they received $275,000 from patient fees. Patients who were charged a fee then received a total of $160,000 in MBS rebates. This becomes important later, so I've put a box around it there.
The GPs at this practice earned revenue of around $1.2 million from GP non-referred attendance services in 2025. It’s important to note, this doesn't include any revenue generated from non-GP NRA services, such as procedural items, as this wouldn't be counted towards the bulk billing requirement of the program.
Over the next few slides, you'll see that we adjust the current revenue to consider the positive impacts of the expansion of eligibility for bulk billing incentive items to form a baseline income for every practice. We then simulate the revenue each practice would make if it joined BBPIP and bulk billed all of its services.
If that income is greater than the baseline income, then the practice is deemed to be financially better off joining BBPIP.
As promised, the next step is to adjust the practice's current income to account for additional revenue from expanding eligibility for bulk billing incentive items to all Australians. To do this, we find the number of GP NRA services that GPs at this practice bulk billed to non-concessional patients in 2024.