Results of an Australian survey, published in Social Science & Medicine, found patients would be willing to make voluntary and patient-chosen payments of AU25 in return for shorter waiting times and longer consultations with general practitioners (GPs).
The survey of 1,457 Australian adults in April 2019, by Monash Business School and Monash School of Primary Health and Allied Health Care, found 39% would prefer to set their own out-of-pocket payment than be bulk billed or pay a compulsory gap fee. Four in 10 Australians also believe patients should be able to determine how much they pay for a GP visit.
As well as this, results suggested patients preferred lower compulsory co-payments, services with higher patient satisfaction ratings, choice of doctor and $0 suggested voluntary contribution for PCGP services.
In line with these findings, the study proposed a new ‘Patient-Chosen Gap Payment’ (PCGP) funding model where patients could choose to pay any amount for their GP consultation from nothing to potentially much more than the average out-of-pocket ‘gap’ payment.
It suggested patient-chosen prices for primary care could generate an extra $1.48 billion in revenue and boost patient-centred care.
Policy-simulations suggested high-quality PCGP services could obtain market share of up to 39% and voluntary contributions of up to AU$25.36 per service, potentially adding AU$1.48 billion in revenue and funding for primary care at no cost to government.
Researcher concluded that “PCGP services aligned with patient preferences could capture significant market share and substantially increase revenue to general practice.”
Associate Professor Duncan Mortimer, researcher at Monash Business School’s Centre of Health Economics, said the proposal did not mean GPs would see patients for ‘free’ as doctors would continue to receive the Medicare rebate for each patient.
“This line of research has the potential to reinvigorate debate around the delivery and funding of primary care in Australia,” said A/Prof Mortimer.
“What we can say is PCGP services are acceptable to patients and may offer a viable alternative pricing model in the market from primary care services. However, they must be delivered at high quality and with careful design if they are to capture market share and increase out-of-pocket contributions.”
The researchers said GP groups had long argued that the Medicare rebate was insufficient to cover costs and did not reflect the value of GP visits.
Co-author and GP, Dr Daniel Epstein said, “‘Patients’ willingness to make voluntary contributions may come as a surprise. Our research found, given the choice, women in more affluent areas were more willing to pay a little extra, while men in disadvantaged areas were more likely to stick with bulk billed services.”
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Published with permission of Optometry Australia.
