A significant shift has occurred in Australian primary care, with the number of general practices offering free bulk-billed appointments almost doubling in little over a year. This surge follows the introduction of enhanced federal government incentives designed to make visiting a doctor more affordable for patients.
Incentives Drive Dramatic Increase in Bulk Billing
According to a national analysis by the online health directory Cleanbill, the proportion of clinics that fully bulk bill all eligible patients jumped to 40.2% by the end of 2025. This marks a dramatic rise from just 20.7% the previous year. The research, published in early 2025, attributes this change directly to a policy implemented by the Albanese government in November of the preceding year.
The key change was the introduction of an additional 12.5% payment on Medicare benefits for practices that commit to bulk billing every eligible patient for every eligible service. Previously, similar incentives were largely restricted to supporting children under 16 and Commonwealth concession card holders.
Regional Disparities and Rising Costs for Others
Cleanbill's survey, which involved calling nearly 6,900 clinics between November and mid-December 2025, found that 1,007 practices had switched from private or mixed billing to full bulk billing since the start of the year. However, the data paints a picture of uneven access across the nation.
While over half (51.9%) of clinics contacted in New South Wales reported full bulk billing, and 43.6% in Victoria, other regions lagged considerably. In Western Australia, the figure was just 19.8%, and in the Australian Capital Territory, only around 12 out of 101 clinics surveyed offered the service. For patients not bulk billed, the news is less positive, with out-of-pocket costs rising by an average of 13.5% over the year.
Government Claims and Expert Critique
Federal Health Minister Mark Butler challenged the specifics of Cleanbill's data, stating it "cannot be relied upon" due to methodological issues like excluding clinics that did not answer questions. He pointed to official government figures indicating that since November, more than 3,200 practices are now fully bulk billing, including almost 1,200 that were previously mixed billing.
Despite the apparent success in boosting numbers, health policy experts warn the changes fail to tackle deeper structural problems. Peter Breadon, Health Program Director at the Grattan Institute, said the rebound was expected but criticised the policy for not targeting funding based on patient need.
"We've taken that away, while countries like New Zealand are moving in the opposite direction, tying funding to disadvantage, complexity and rurality," Breadon stated. He argued the new incentive, which applies to all patients equally, represents a step backwards from the previous model that explicitly prioritised concession card holders and children. He advocates for a funding model where "money follows need" to better support clinics in 'GP desert' areas and those serving disadvantaged communities.
The government has also highlighted other measures to improve healthcare access, including the expansion of Medicare Urgent Care Clinics and the launch of the 1800Medicare advice line. However, the debate continues on whether the bulk billing incentive changes provide a lasting solution or merely a temporary financial fix that overlooks the most vulnerable patients.
