Healthscope to slug Bupa and Australian Health Service Alliance out-of-pocket fee after failed funding talks

Hospitals giant Healthscope has opened a war front against Bupa and other health insurers, slugging its members with out-of-pocket fees of up to $100 after the insurers refused to join rivals in footing soaring medical costs. Healthscope blamed the selective “Hospital Facility Fee” that will take effect next month for patients covered by Bupa and the Australian Health Service Alliance on “these insurers’ failure to sustainably cover the cost of patient care”. “Unfortunately, Bupa and the AHSA refuse to fund Healthscope hospitals at a level that allows us to remain viable,” it said. From November 26, members of Bupa and the alliance, which covers not-for-profit funds HBF, Australian Unity, Defence Health and GMHBA, will be slugged $100 for an overnight hospital stay and $50 for same-day admissions. Patients receiving chemotherapy, renal dialysis or palliative care will be exempt, as will those in day mental health and rehabilitation programs. Healthscope and other operators have warned they will have to close hospitals without additional funding from health insurers to meet their rising costs of treating patients. Insurers have countered they would have to lift insurance premiums to cover the extra contributions. Nonetheless, Medibank Private, NIB and HCF were reported last month to have agreed to out-of-cycle funding payments in the “tens of millions of dollars” for Healthscope. Healthscope said on Tuesday these funds had “improved their funding of patient care in Healthscope hospitals”, adding they had “worked constructively ... to reach these agreements which are in the best interests of patients”. Healthscope’s chief executive Greg Horan insisted the group had been trying to avoid charging the out-of-pocket fee, but “Bupa and the Alliance funds have left us with no choice”. “We are introducing this fee due to these insurers’ failure to sustainably cover the cost of patient care in our hospitals,” he said. “Members of Bupa and the Alliance insurers ... should also be aware that they have the option of switching their cover to any of the other health insurers who fund our hospitals sustainably. If they do this they will not be subject to the new fee, and so long as they move to a comparable product, they should not need to re-serve waiting periods.” More to come.