The recent announcement to strengthen Medicare funding for GP bulk-billing from 1 November 2025 is an investment in primary care that brings us closer to what Medicare (in general practice) was initially envisioned to be—a genuine health insurance scheme. Introduced in the 1980s, Medicare’s aim was to ensure access to healthcare without significant out-of-pocket costs. Over the years, we’ve veered far from that vision – with Medicare rebates trailing inflation and then actually being frozen – but this initiative helps us catch up.
Extending bulk-billing incentives and introducing new programs for general practices may significantly improve access, particularly for those facing financial hardship. There may also be significant negotiation, or horse-trading, about this policy after the election. However, right now, there are some missed opportunities.
What is changing?
The Australian Government is proposing two key changes to Medicare to make it easier for Australians to see a GP without having to pay a gap fee.
- From November 1, 2025, GPs will be able to claim bulk billing incentive items when they bulk bill any Medicare-eligible patient, not just children under 16 and Commonwealth Concession Card holders. This means that more GPs will be encouraged to bulk bill all of their patients.
- The government is also launching a new Bulk Billing Practice Incentive Program, to encourage thousands of GP practices to bulk bill every patient. Participating practices will receive an additional 12.5% loading payment on every $1 of MBS benefit earned from GP non-referred services, split between the GP and the practice. To participate in the program, practices will need to commit to bulk bill all of these GP services, advertise their participation in the program, and be registered with MyMedicare.
The federal opporsition has committed to implement these changes if they win government.
Why This Investment Matters
The promise of better access to GPs is hugely encouraging. According to recent ABS analysis, nearly 9% of Australians delayed or avoided visiting their GP last year due to the cost—up from just 3.5% in 2022. For younger Australians aged 25–35, this figure jumps to 15%. This represents a growing and absurd trend whereby affordability is a barrier to primary care, yet comparatively expensive hospitals are free for consumers. Consumers state to us consultants time and time again that they want and need better access to GPs.
Key elements of this reform, such as rural loadings, are particularly welcome. Rural and remote communities are losing GPs and GP clinics due to financial pressures and workforce shortages. These new payments could help halt the further closure of practice in thin markets.
For general practices, the new Bulk Billing Practice Incentive Program provides participating clinics with a 12.5% loading payment on all Medicare benefits for GP services if they offer bulk-billing universally. This could provide many practices with the financial support to remain viable. However, the Department still predicts there will be a couple of thousand practices who elect not to, or cannot, fully bulk bill.
Additionally, the reform includes funding for GP and nurse training to expand the workforce and enhance the quality of care available to patients—another necessary step for long-term sustainability, though with a considerable lag until we see the benefits.
The Opportunities
This reform offers an opportunity that stakeholders across the sector — Primary Health Networks (PHNs), general practices, and community-based providers—could leverage to further expand access and reduce health inequalities. We believe some promising opportunities include:
- Engaging Hard-to-Reach Populations
Projects targeting groups underserved by traditional general practice models are now more viable due to the funding boost. For instance, targeted strategies through genreal practice (working with GP and nurse leaders) to engage people experiencing homelessness, younger people, men, and culturally and linguistically diverse communities could be explored.
- Youth-Friendly Primary Care
With a rising percentage of young people delaying primary care due to cost, there is potential to make primary care more accessible and attractive for this demographic. The Bega Teen Clinic comes to mind as a great example of youth-friendly primary care to meet community need.
- Enhanced Outreach through PHNs
PHNs can collaborate with clinic leaders about whether we can use these new funding mechanisms to extend programs like homeless outreach initiatives, nusre clinics or pop-up primary care services to ensure these reforms reach populations who traditionally face barriers in accessing care.
But It’s Certainly No Silver Bullet
While this initiative is a step forward, it’s important to discuss where it falls short. Several missed opportunities highlight the need for further reform and ongoing advocacy:
- Lack of Multidisciplinary Care Funding
A key limitation of this initiative is its narrow focus on general practitioners. While GPs play a critical role in care delivery and management, they (and consumers) work closely with and rely on multidisciplinary teams. Consumers will still face significant out-of-pocket costs for allied health and specialist services. For example, 25.6% of Australians delayed seeking psychology services due to cost—a barrier this reform does not address. The nurse practitioner is another highly skilled workforce being held back due to a lack of support from many quarters.
- GP Workforce Concerns
The reform embeds GP-led care at a time where the GP workforce is critically overstretched. The workforce training investment is very welcome, but there will be a long lag until it comes to fruition. The reform does not support the viability of roles played by other highly skilled health professionals, such as nurse practitioners and pharmacists, who could help meet demand while maintaining safe and effective care delivery.
- Overlooking Non-Traditional Models of Care
Many people who lack access to primary care —such as those experiencing homelessness—are less likely to engage with traditional general practices in any case. Without targeted investments in outreach or community-based care, as we flagged above, these populations are unlikely to see the benefits of reform.
- Ignoring Scope of Practice Recommendations
The recently concluded Scope of Practice Review proposed innovative solutions to optimise Australia’s health workforce, including changes to the Medicare system to empower and better integrate health services with the use of nurse practitioners, allied health professionals, and pharmacists to practice at their full scope. These recommendations are not addressed in the reform, representing a missed opportunity to maximise the efficiency of our broader workforce.
What’s Next?
Don’t get us wrong – at Larter, we are big advocates for the financial viabilty of general practice. Too often we have seen frazzled practice managers and principals tearing their hair out due to the Medicare rebate freeze. The Strengthening Medicare reforms represent a foundational investment in primary care—one that has the potential to address immediate challenges around affordability and access to GPs for many Australians.
However, we also need more tangible reform (not just pilots) focused on rolling out innovative models of care that have proven to have worked; workforce optimisation across disciplines to meet community need; and broader system support for multidisciplinary team health services in general.
That aside, to fully capitalise on this $8b investment, collaboration between PHNs, general practices, and community health providers will be important.
At Larter, we’re particularly keen to work with partners to identify how this reform can be used to expand GP access to underserved populations. Projects like outreach to people experiencing homelessness, and making primary care more youth-friendly, are potential starting points. The possibilities are vast if we work together to meet local community need.
If you’re ready to explore how you can unlock these opportunities, do get in touch – we’d love to connect and explore the possibilities with you.