The average out-of-pocket cost for non-bulk billed GP attendances varied over time between states and territories (Figure 7).
People in the Australian Capital Territory (ACT) paid the highest annual average out-of-pocket cost of $50 for a GP attendance during 2023. The highest average out-of-pocket cost in the ACT was $55 for a GP attendance (adjusted for inflation) which occurred between 2018 and 2020.
South Australia paid the lowest average annual out-of-pocket cost of $36 for a GP attendance during 2023. Within South Australia, the highest average annual out-of-pocket cost per service for a GP attendance was $40 between 2018 and 2021 (adjusted for inflation).
The Northern Territory experienced a large decline in the average annual out-of-pocket cost for a GP attendance between 2021 and 2022. The average annual out-of-pocket cost fell by $15 (from $57 in 2021 to $42 in 2022), followed by a small decrease to $40 in 2023.
The fall in out-of-pocket costs occurred at the same time there was a drop in bulk billing rates. Between 2021 and 2022, the annual GP bulk billing rate in the Northern Territory fell from 91% to 81% (Figure 2). Typically, decreases in bulk billing rates are associated with increasing out-of-pocket costs to patients. In this instance, however the patient out-of-pocket costs decreased.
Analysis of the billing patterns of GPs within the Northern Territory across 2021 and 2022 identified several GPs who moved from exclusively bulk billing in 2021 to mixed billing (a combination of bulk billing and patient billing) in 2022. Further analysis of those GPs who moved to mixed billing in 2022 identified that they generally charged a lower out-of-pocket cost to patients compared to the GPs who were already patient billing in 2021. This led to the drop in average out-of-pocket costs for non-bulk billed GP attendances in the Northern Territory in 2022.
