True cost comparison: local hire vs offshore healthcare admin in Australia

When practice managers compare offshore and local admin options, the instinct is often to compare the hourly rate or monthly retainer. That is the wrong comparison. The true cost of an Australian admin hire extends well beyond the wage rate, and most healthcare businesses significantly underestimate it. This post builds a realistic cost model for both options so you can make the comparison on the right terms.

The figures used below are indicative for a full-time, experienced medical receptionist or practice administrator in metropolitan Australia in 2025. Adjust the base salary for your location, role seniority, and current market conditions, but the cost structure — the ratio of total employment cost to base salary — holds broadly across the sector.

The true cost of an Australian admin hire

The award rate for a Medical Receptionist under the Health Professionals and Support Services Award 2020 (HPSS Award) at Grade 2 typically sits between $58,000 and $65,000 per year for a full-time equivalent in a metropolitan healthcare business, depending on classification level and any above-award arrangements. Call it $62,000 as a working base.

Now add the statutory and operational costs that come with the hire.

Statutory add-ons

• Superannuation (11.5% from 2024–25, rising to 12% in 2025–26): $7,130 per year.
• Annual leave loading (17.5% on four weeks leave): approximately $830 per year.
• Payroll tax: applies once your total wages bill exceeds the state threshold — in NSW the threshold is $1.2 million; in VIC $700,000. Multi-practitioner healthcare businesses are often caught. At the NSW rate of 5.45%, the cost per employee is $3,379 per year once threshold is exceeded.
• Workers compensation insurance: varies by state and risk classification; a typical rate for healthcare admin is 0.7–1.0% of wages, or approximately $434–$620 per year.
• Long service leave accrual: typically 1/60th of ordinary pay per year. At $62,000, that is $1,033 per year as an accrued liability.

Total statutory add-ons (excluding payroll tax): approximately $9,600 per year. Including payroll tax where applicable: $12,980 per year.

Operational overhead costs

Statutory costs are only the start. An onsite admin hire carries a set of operational overhead costs that are easy to overlook because they are not on the payroll line.

• Physical desk and equipment: a workstation, monitor, keyboard, phone, and headset. Capital cost of $2,500–$4,000 amortised over three years: approximately $1,000–$1,333 per year.
• Practice management software seat licence: most platforms charge per user. A Best Practice or Cliniko seat at $50–$100 per month adds $600–$1,200 per year.
• IT support and device management: if your IT managed service provider bills per device, add another $600–$1,200 per year.
• Training and onboarding: a new hire takes 4–8 weeks to reach full productivity. At $62,000 base, four weeks of partial productivity costs approximately $2,400 in time value.
• Recruitment cost: using a recruitment agency typically costs 12–18% of first-year salary, or $7,440–$11,160 per placement. Even if you recruit directly, job board advertising and internal interview time typically cost $1,500–$3,000.

Adding a mid-range estimate of operational overhead — $3,600 in annual software and IT, $1,200 in amortised equipment, $2,000 in recruitment amortised over three years — brings the total annual overhead addition to approximately $6,800.

The fully-loaded cost of an Australian hire

Pulling the figures together.

• Base salary: $62,000
• Statutory costs (super, leave loading, workers comp, LSL accrual): $9,600
• Operational overhead: $6,800
• Total annual cost: approximately $78,400

Add payroll tax if applicable and the figure moves to approximately $81,800. In a high-cost city like Sydney or Melbourne, where above-award pay and CBD office costs are more common, the realistic total can reach $85,000–$90,000 for a senior admin role.

The per-hour cost on a 38-hour week, 48 working weeks (accounting for leave and public holidays) is approximately $43–$48 per productive hour.

The true cost of an offshore healthcare VA

Offshore healthcare VA arrangements through a provider like HealthDoers are structured as a fixed monthly engagement fee covering the VA’s compensation, employer contributions under Philippine law, provider management overhead, compliance infrastructure, and training. The healthcare business pays one invoice.

Monthly engagement fees for a full-time, healthcare-trained Filipino VA with Australian healthcare business experience typically range from AUD $2,800 to AUD $3,800 per month at current rates (2025), depending on role complexity and seniority. Call it $3,300 per month, or $39,600 per year, as a working figure.

What is included in that figure that you do not pay separately.

• The VA’s salary and all Philippine statutory contributions (SSS, PhilHealth, Pag-IBIG, 13th month pay).
• Provider management overhead and quality assurance.
• Pre-placement healthcare and privacy training.
• Replacement guarantee during the guarantee period (typically 90 days) at no additional recruitment cost.
• No payroll tax liability in Australia.
• No physical desk, workstation, or onsite IT overhead.

Software seat licences are still required — your VA will need access to your practice management system, so that cost carries over. Add $1,200 per year for system access. Total: approximately $40,800 per year.

On a productive-hours basis (assuming standard Manila working hours, 48 weeks), the per-hour cost is approximately $22–$25.

The comparison in numbers

• Australian full-time admin hire (total cost): $78,400–$90,000 per year; $43–$48 per productive hour.
• Offshore full-time healthcare VA (total cost): $40,800–$42,000 per year; $22–$25 per productive hour.
• Annual saving: approximately $36,000–$48,000 per full-time equivalent.
• Cost reduction: 45–55% on a total employment cost basis.

These figures do not account for the less tangible costs of onsite admin turnover — the average tenure of a medical receptionist in Australia is under two years, meaning most practices bear one to two recruitment and onboarding cycles per decade per role. Each turnover event costs $10,000–$15,000 in direct and indirect costs. Offshore arrangements through structured providers tend to have lower turnover, in part because the VA’s role is a well-regarded professional position within the Filipino healthcare administration sector.

What the saving is really for

It would be a mistake to frame the offshore cost advantage purely as a reduction in the wages bill. The more useful framing is: what do you do with the $36,000–$48,000 per year you are not spending on an onsite admin hire?

For a single-practitioner GP or specialist, that sum covers a meaningful portion of an additional consulting session per week. For a four-practitioner group healthcare business, it funds a clinical care coordinator role or a significant investment in patient experience infrastructure. For an NDIS provider, it materially changes the unit economics of plan management and support coordination.

The cost comparison between local and offshore admin is ultimately not a question about wages — it is a question about what model of resourcing best supports the clinical and business goals of your practice. For process-driven administrative work, the case for offshore resourcing is compelling on the numbers. The practices that benefit most are those that make the comparison clearly, plan the reinvestment deliberately, and approach the offshore arrangement as a long-term structural decision rather than a short-term cost reduction exercise.