Healthcare directory Cleanbill’s first Blue Report since the Australian Government expanded the bulk-billing incentive to non-concession patients has been released.
The government’s decision appears to be vindicated with the report finding that over 40 per cent of GP clinics nationwide are fully bulk-billing.
Cleanbill chief executive James Gillespie said they were able to collect data for 6877 GP clinics across the country and compare thepricing and availability data against the same data that have collected over the last few years.
“What we’ve seen, at least in the headline findings, it is a significant uptick in the number of fully bulk billing GP clinics across the country, in fact, the proportion of fully bulk billing GP clinics across the country has almost doubled since last year, which is a massive increase.
“We’ve also seen a surge in average out-of-pocket costs so if you’re not able to go and see one of the 40 per cent of GP clinics across the country that are fully bulk billing, your average out-of-pocket costs have increased substantially over the last year as well.”
In the three years prior, Cleanbill found bulk-billing rates had been on a steady decline from 35.1 per cent in 2023 to 24.2 per cent in 2024 and 20.7 per cent in 2025.
The government incentive appears to have helped address bulk-billing rates in ‘deserts’ such as Tasmania, where a third of clinics are now bulk-billing (37 throughout the state) compared to none last year, while the Northern Territory rose 47.6 per cent to 57.1 per cent of clinics.
Victoria experienced a 24.5 per cent rise to 43.6 per cent of clinics bulk-billing, while Western Australia (19.8 per cent, up 13.6 per cent) and the Australian Capital Territory (11.5 per cent, up 8.2 per cent) are the only states or territories with a bulk-billing rate below 20 per cent.
Mr Gillespie said it’s an encouraging sign and they’re always keen to see there being more bulk billing on the ground.
“With Tasmania it’s a really interesting case study, Tasmania and the Northern Territory as well, in that we’ve often seen these less urbanised jurisdictions with higher increases in fully bulk billing proportions when compared with more urbanised jurisdictions like WA and the ACT,” he said.
“The Northern Territory and Tasmania saw two of the highest increases in the proportion of fully bulk billing clinics, and they are almost entirely made up of rural and regional areas, whereas you compare that to the ACT which is entirely made up of metro and WA where a large proportion of the clinics are concentrated in metro areas and for those jurisdictions you’ve seen some of the lowest increases in proportion of fully bulk billing clinics.
“That’s an interesting reflection on how the incentive changes are playing out amongst clinics across the country.”
Minister for Health Mark Butler was asked about the report in an interview with ABC Radio National, and despite previously holding and maintaining a view that Cleanbill’s data ‘should not be relied upon’, said if there are other parts of the country that also are finding it difficult to see levels of bulk billing that we enjoy in other parts of the country, then they’re open to looking at intervention.
“It’s really hard to tell why ACT clinics charge such high gap fees and have such low bulk billing rates compared, for example, to Western Sydney where it’s pretty expensive to find property and run a business, but they have bulk billing rates over 95 per cent,” he said.
“That’s why we’ve decided to intervene in the market in the ACT and to support the establishment of a number of new general practices which bulk bill all of their patients, because we frankly think there needs to be more competition in a market like that.
“Since 1 November, only 10 weeks or so ago when that record investment took effect, more than 1200 general practices across the country have moved from charging gap fees, which is what they were doing just in October, to bulk billing all of their patients all of the time and that number of general practices is increasing every day.”
Nationally, Cleanbill found the average out-of-pocket cost rose 13.5 per cent up to $49.23, likely impacted by lower-charging clinics being those most likely to make the switch to fully-bulk billing. The same figures applied to Victoria a rise of 14.7 per cent, up to $48.18.
Mr Gillespie said noticing this, they also completed an analysis that controlled for these changes.
“We removed all the clinics that have become fully bulk billing in 2026 from our 2025 numbers and then recalculated our 2025 numbers so that we were effectively doing it on the same clinic spaces and only seeing the average out of pocket cost increase for clinics that have remained private or mixed billing over both years that we’ve been considering them,” he said.
“What we found is that there was still a 6.8 per cent increase in average out of pocket costs over the course of 2025, which is a fairly substantial increase, even over and above what we regularly see, the increase between 2024 and 2025 was only 4.1 per cent.
“So it’s partly due to that statistical difference, but also it’s partly due to the reality on the ground.”
Mr Butler was also asked about this in the interview with ABC Radio National.
“That’s always been the case, and gap fees have been rising for several years, which is exactly why we’ve put this focus on increasing bulk billing rates,” Mr Butler said.
“We want to make sure that as many Australians as possible feel able to go to a GP when they need to rather than when they feel they can afford to.
“Yes, those gap fees have been increasing for years now, that’s precisely why we’re putting such an effort and such significant investment into turning bulk-billing rates around.”
6877 clinics were included in Cleanbill’s data collection, while 286 clinics did not respond, which has been a criticism of the health minister.
Cleanbill will release an electorate breakdown of the data collection later in the year and Mr Gillespie said it will be really interesting to see how these newly fully bulk billing clinics across the country stack up in different areas, as well as see how many clinics retain bulk-billing in 2026.
“What’s been really interesting is over the course of this collection period, our researchers and callers have come across clinics saying that they had switched to fully bulk billing, but that they were only doing so for a 6 to 12 month trial period,” he said.
“Each of these clinics has to make the decision on their own billing based on the economic factors that they’re facing, and their perception of those…which makes it very, very difficult to predict how many clinics will take up these changes in future, how many will hold on to them, and how many will drop them.
“Now, we don’t have exact numbers on that, but the fact that we were hearing it at all means that there’s still some uncertainty amongst clinics as to what the impact of these changes will be on their bottom line, and so as a result, uncertainty as to where we’re going to see these numbers go in future.”
