General practice compliance costs

Many Commonwealth policies and programs impact specifically on GPs and the way general practices are managed and operated.

Under the Commission's base case, in 2001-02 the estimated incremental administrative and compliance costs resulting from Commonwealth policies and programs amounted to about $228 million (about 5 per cent of GPs' estimated total income from public and private sources).

• This is equivalent to about $13 100 per GP per year (for GPs who work at least one day per week).

Estimates are indicative only and sensitive to assumptions about GPs' annual earnings and the extra time spent on administrative activities attributable to Government programs.

• For example, if activities such as qualifying for vocational registration would be undertaken anyway, the estimated administrative costs attributable to Commonwealth requirements could be as low as $85 million.

Some GPs report rising stress and frustration associated with completing forms and complying with administratively complex programs, the increasing accumulation of forms and programs, and conflicting priorities.

• However, it is difficult to quantify these intangible costs, and these are not included in the Commission's estimates.

For many programs, GPs receive Government payments that exceed the measurable administrative and compliance costs.

In the base case, three programs aimed at encouraging high quality care — Practice Incentives Program, vocational registration and Enhanced Primary Care — account for over three-quarters of measurable costs.

Form filling by GPs accounts for a small share of the measurable administrative and compliance costs, but is a significant source of stress-related and other intangible costs.

A range of options is available for reducing both tangible and intangible administrative and compliance costs.

The costs to GPs and their practices from Commonwealth programs are significant, but there is scope to reduce them, according to a report released by the Productivity Commission today.

The report — General Practice Administrative and Compliance Costs — was requested by the Commonwealth Government. It provides estimates of the additional costs borne by GPs and their practices associated with Commonwealth programs that affect them.

Under the Commission's base case, costs to GPs resulting from a range of Commonwealth programs are estimated to have been about $228 million in 2001-02 (averaging $13 100 per GP working at least one day per week).

The Commission noted that there is debate about whether some activities included in this estimate are really an additional cost for GPs. If activities such as qualifying for vocational registration would be undertaken anyway, the estimated costs attributable to Commonwealth requirements could be as low as $85 million.

"It is important that governments consider the cost impacts on GPs when implementing new programs affecting general practice", said Commissioner, Helen Owens. "Administrative and compliance costs should be kept to the minimum necessary to achieve the community-wide benefits of programs".

For many programs, GPs receive Government payments that exceed the measurable administrative costs, although the Commission has not formed a view about whether payments are too high or too low.

The Commission found that there were also potentially significant costs arising from the stress of complying with programs, but it was unable to quantify them.

The Commission has made a number of recommendations aimed at reducing GP administrative costs without compromising the benefits these programs deliver. These include departments:

• assessing GP administrative costs when conducting program evaluations; and
• remunerating GPs out of their own budgets and adopting consistent principles for doing so.

Preliminaries
Cover, Copyright, Foreword, Terms of reference, Contents, Acknowledgments, Abbreviations

Overview
Key points, Overview, Recommencations and findings

1 Introduction
1.1 Background to the study
1.2 Scope of the study
1.3 Conduct of the study
1.4 Report structure

2 General practice in Australia
2.1 GPs
2.2 Practice types
2.3 Other practice staff
2.4 Sources of revenue

3 Commonwealth policies and programs
3.1 Participating in programs to influence the quality and availability of GP services
3.2 Providing information to assist departmental assessments
3.3 Participating in programs to promote population health
3.4 Responding to Government surveys
3.5 Payments to GPs

4 Defining and measuring GP administrative costs
4.1 GP administrative costs in context
4.2 Defining GP administrative costs
4.3 Activity-based costing
4.4 Distinguishing between normal and incremental costs
4.5 Commission's approach

5 Estimating GP administrative costs
5.1 Method used to estimate GP administrative costs
5.2 Measurable costs
5.3 Intangible costs

6 Reducing GP administrative costs
6.1 Assessing program costs and benefits
6.2 Remunerating GPs for providing medical information
6.3 Cumulative GP administrative costs
6.4 Information collection
6.5 Use of information technology
6.6 Addressing conflicting priorities
6.7 Summary

Appendix A Conduct of the research study
A.1 List of submissions received
A.2 List of visits
A.3 Organisations represented on the advisory committee

Appendix B Department of Family and Community Services
B.1 Assistance for people with a disability, illness or injury
B.2 Assistance for people caring for someone who is frail-aged, ill or has a disability
B.3 Employment assistance for people with a disability, illness or injury
B.4 Data

Appendix C Department of Veterans' Affairs
C.1 Health-care services
C.2 Disability compensation
C.3 Income support
C.4 Military Compensation Scheme
C.5 Data

Appendix D Department of Health and Ageing
D.1 Programs to influence the quality and availability of general practice services
D.2 Programs to promote population health
D.3 Programs relating to providing information to departments and others
D.4 Data

Appendix E Sources of information and data
E.1 Department data
E.2 Pilot survey
E.3 Focus group discussions
E.4 Independent review of Commonwealth Government forms
E.5 Case studies

Appendix F Estimating GP administrative costs — further details
F.1 Method used to estimate GP administrative costs
F.2 Time and cost data used by the Commission
F.3 Sensitivity analyses

References