Failed talks see 42 private hospitals cut from funds’ lists

Failed talks see 42 private hospitals cut from funds’ lists.

Million Aussies cut from hospital network

As more people drop their private health insurance and elective surgery wait times at public hospitals blow out beyond 109 days, a major row is threatening the health insurance of more than one millions Australians.

Talks between six members of the Australian Health Services Alliance (AHSA) and Healthscope – a for-profit Australian company that operates private hospitals, medical centres and international pathology services – have broken down. The talks for a new three-year contract started in November last year.

The result is that more than one million Australians will be unable to access treatment at 42 Healthscope private hospitals after 8 June without incurring out-of-pocket costs.

Emergency hospital admissions will continue until 7 September.

The AHSA is a non-profit that negotiates agreements with private hospitals on behalf of 27 small to medium-sized health funds. It is the third largest health insurance buying group after Bupa and Medibank, according to the Australian Financial Review.

The six affected AHSA members are: Australian Unity, Teachers Health Fund, CUA Health, Reserve Bank Health Society, CBHS Corporate Health and CBHS Health Fund.

Healthscope said an agreement could not be reached on the rate offered to it by the health funds.

“The decision not to recontract has been made with regard to the future commercial sustainability of our business as we must be appropriately reimbursed for the work our people do every day, and at a rate that allows us to be able to invest in our facilities and equipment so we can continue to deliver world-class care for patients,” a spokesperson said.

“This was not a decision we took lightly and is not our preferred option, but we are committed to securing arrangements with private health insurers that maintain the financial viability of private hospitals.”

Teachers Health Fund, a not-for-profit and member-owned insurer that represents more than 160,000 teachers and their families, says Healthscope’s decision to terminate the agreement is “irresponsible and unconscionable”. It claims Healthscope was being unreasonable by charging “additional fees” for industry-minimum standards that would have resulted in an unacceptable and unfair increase in costs for its members.

“This opportunistic and exploitative behaviour demonstrates the lack of competition faced by Healthscope and its ability to make take-it-or-leave-it offers to health funds,” Teachers Health Fund chief executive Brad Joyce said on Monday.

“It unfairly targets teachers who are already facing personal and professional challenges during COVID-19.

“Considering the current climate, supporting the physical and mental health needs of our teachers should not be used as a bargaining tool.”

Healthscope hospitals affected

Australian Capital Territory

National Capital Private Hospital

New South Wales

Campbelltown Private Hospital

Hunter Valley Private Hospital

Lady Davidson Private Hospital

Mosman Private Hospital

Nepean Private Hospital

Newcastle Private Hospital

Northern Beaches Hospital

Norwest Private Hospital

Prince of Wales Private Hospital

Sydney Southwest Private Hospital

The Hills Private Hospital

The Sydney Clinic

Tweed Day Surgery

Northern Territory

Darwin Private Hospital

Queensland

Brisbane Private Hospital

Gold Coast Private Hospital

Pacific Private Hospital

Peninsula Private Hospital

Pine Rivers Private Hospital

Sunnybank Private Hospital

South Australia

Ashford Hospital

Flinders Private Hospital

Griffith Rehabilitation Hospital

Parkwynd Private Hospital

The Memorial Hospital

Tasmania

Hobart Private Hospital

St Helen’s Private Hospital

Victoria

Bellbird Private Hospital

Dorset Rehabilitation Centre

Frankston Private Hospital

Holmesglen Private Hospital

John Fawkner Private Hospital

La Trobe Private Hospital

Knox Private Hospital

Melbourne Private Hospital

North Eastern Rehabilitation Centre

Northpark Private Hospital

Ringwood Private Hospital

The Geelong Clinic

The Melbourne Clinic

The Victoria Clinic

The Victorian Rehabilitation Centre

Western Australia

Mount Hospital

About 44 per cent of Australians have private hospital cover, according to the latest Australian Prudential Regulation Authority (APRA) data – a drop of 0.2 percentage points in the quarter compared to September 2019. The figure was pre-coronavirus.

Does this breakdown affect your private health insurance? Are you fearful that such a standoff will spread to other networks?

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    COMMENTS

    To make a comment, please register or login
    Horace Cope
    19th May 2020
    4:19pm
    The key to this article is the phrase "for-profit Australian company". The company running the hospitals in question is a business which wants to make a profit for its shareholders. It appears they have increased the contributions from health insurers and 21 funds represented by AHSA have agreed and 6 have declined. We are not told what BUPA and Medibank have done with the increase sought by Healthscope. As I see it, a very small minority is refusing to pay for a service for their members and it has to be asked if the members of those 6 funds were asked whether they were agreeable to pay the increase.
    Fedup
    19th May 2020
    5:56pm
    The health funds work for their members. As TH informed it’s members,

    “Unfortunately, their new terms included higher charges for our members’ hospital admissions, and this would’ve had an adverse impact on premiums.

    Healthscope’s proposal also included additional charges for them to comply with industry minimum standards for rehabilitation and mental health services. We want the best quality of care for our members and we expect industry minimum standards to be met as a baseline.”

    Healthscope wants to charge more than other private hospitals. I’m not happy as my specialists operate at two of the hospitals on the list. Hopefully they will change hospitals.
    KSS
    19th May 2020
    6:59pm
    All very well Fedup, but it now leaves people like me having paid for private hospital cover for the next 12 months which on June 14 becomes invalid. I am left with a hospital cover insurance I can't use at my local hospital. And my local hospital is the only hospital given that two others have been closed. Now in an emergency I would still be treated of course but for anything else that might arise in the next year, my private insurance is useless!

    Calling the insurance company elicited absolutely no assistance, advice or anything else except to say that if I did decide to go elsewhere I would not have to serve waiting periods! Then they said that most insurance companies are in the same boat, so where would I go anyway. IE you may as well stay with us because other insurances are the same. Pay for something you will not be able to use in the event you need it!!!!
    Fedup
    19th May 2020
    7:33pm
    KSS, I agree. But I think the fault is with Healthscope, and they need to rethink their position or they will lose patients and doctors.
    Maggie
    19th May 2020
    11:48pm
    It would be interesting to know how many specialists own shares in the profit making companies.
    Maggie
    20th May 2020
    10:37am
    KSS, I have just reread your input here.
    There are no words to express how shamefully you have been treated.
    This is doubly shocking because it's not difficult to deduce that you are a professional in the medical world.
    There has to be a way to get justice for you and others who are similarly affected.
    Oxleigh
    19th May 2020
    5:03pm
    Politicians need to pull their heads in, there is not one industry or service that the governments have privatised that has worked for the general public, look at rail, electricity, water, communication, private education, health etc. All the talk about competition being good for lower prices and service etc, is just political talk, all it does is line the pockets of polies who can't see past the next election.
    We as tax payers are subsidising the private schools, the private hospitals, the desalination plants, toll roads while the gov sends all our money overseas to companies who have no interest in the Australian people, just excessive profits at our expense.
    Short term gain for them long term pain for the general public.
    China owns more of Australia the we do now.
    What a laughing stock we are in the rest of the world.
    We will end up having to get permission from the Chinese government if we want to tow our caravans, or travel to another state, this will happen within the next 5 years mark my words, don't tell me you weren't warned.
    We used to have the skills to do all this ourselves but where are all the training and trade apprenticeships gone.
    We are slowly going down the gurgler.
    BLAME THE GOVERNMENTS AND THE IDIOTS WHO BELIEVE THEM.
    Maggie
    19th May 2020
    11:44pm
    "China owns more of Australia than we do".
    You can't make statements like that without substantiating them.
    Pass the Ductape
    20th May 2020
    6:54am
    I think you'll find Oxleigh is speaking metaphorically when he suggests China owns more of Australia than we do Maggie, but the point they're attempting to convey is well worth considering - in my view at least
    Pass the Ductape
    20th May 2020
    6:59am
    I wrongly assumed Oxleigh is a male - I should have written 'they suggest' I suppose, to quieten down the 'pedantics' among us.
    arbee
    19th May 2020
    11:04pm
    Nothing would surprise me with negotiations between health funds and private hospitals any more. A few years ago I had to have keyhole surgery for a hernia which involved them using mesh. It was just day surgery, in at about 9 and back home by about 4pm. All successful and no set backs up to now. Imagine my surprise when i received a letter of demand from the hospital about 4 months later for an amount in the thousands, and giving me 7 days to pay. I rang the hospital and said whats going on, as I was told this procedure was fully covered by my private health cover, and there would be no out of pocket expense for me. They aid, sorry, sorry, it was an admin mistake, we should have billed your health fund, so forget about it we will do that now. Then I brought it to their attention that I was billed for a three day stay in the hospital, whereas it was same day surgery, no overnight stay involved. They replied, that's ok, for that procedure we are allowed to charge for three days even if it is done on the same day. No wonder our premiums go so high with these hospital rip offs happening.
    Maggie
    20th May 2020
    11:11am
    Pass the duct tape, it is anti Chinese comments that stir the pot of racism.
    Perfectly innocent law-abiding, contributing Australian citizens of Chinese extraction have had their livelihoods destroyed by racist bigots.
    This is not the Australian way.
    Big Kev
    21st May 2020
    10:13am
    Many medical providers are charging non refundable administration fees which are beyond the pale. I had a gastric sleeve dome 18 months ago which had a $5000 admin fee and day surgery which had a $500 admin fee. It appears everyone is more concerned with their shareholders wealth health than they are with their patients health!


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