Explore new data on Medicare subsidies and service use by Local Government Area

Data on the use of Medicare Benefits Scheme (MBS or Medicare) funded health services and the subsidy rate they attract is now available by Local Government Area (LGA), remoteness, socioeconomic area and service type.

Over time, Australians have accessed more MBS funded services, with people receiving an average of 17.8 services per person in 2022. Medicare covered three-quarters (76%) of provider fees for these services, with the remainder being covered by the patient (such as out-of-pocket payments or private health insurance).

New releases from the Australian Institute of Health and Welfare (AIHW), Medicare Benefits Scheme funded services: monthly data and Medicare Benefits Scheme funded services over time, allow people to explore how MBS funded service use and subsidies have evolved over time in their LGA, their state or territory or nationally.

‘Since the MBS was established in 1984, it has undergone many changes. For example, the number of services eligible for funding through the MBS has substantially increased from 2,300 in 1984 to 6,000 in 2023,’ said AIHW spokesperson Dr. Adrian Webster (PhD). 

'However, across LGAs, remoteness and socioeconomic areas, we have seen consistent differences in the subsidy rates and service utilisation over time.’

For example, these data show that people living in more remote areas have tended to use less MBS funded services but have a higher subsidy rate compared to those in more urban areas.

On average, people living in Very remote areas used 8.5 services per person in 2022, with a subsidy rate of 85%, where people in Major cities used 18.3 services with a subsidy rate of 76% (crude rates not adjusted for age or other demographic factors).

People living in lower socioeconomic areas also tend to have lower service use but a higher MBS subsidy rate, with a rate of 84%, compared with 72% in the highest.

‘At a national level, the proportion of provider fees paid for through Medicare has fluctuated over time. In the 15 years prior to the COVID-19 pandemic, it remained relatively stable at around 79%,’ Dr. Webster said.

‘Early in the pandemic, the subsidy rate increased in association with a number of measures. This included incentives to encourage GPs not to charge out-of-pocket fees and, later, the rollout of the vaccination program. In the most recent reporting period, the subsidy rate has reduced to well below previous trend levels, reaching 73% in February 2023, the lowest national proportion since the MBS was established.’

The proportion of fees covered through the MBS also varies by service type. Visits to the GP and pathology services have the highest subsidy rates, averaging 89% and 95% respectively during 2022. Anaesthetics and obstetrics have the lowest subsidy rates, averaging 40% and 39% during 2022.

Today’s release and the AIHW’s monthly monitoring of Medicare subsidies will allow recent trends to be understood in the context of the long term and how this varies by local areas.

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