Medibank committed to providing members with quality private hospital access at reasonable prices
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Australia's largest health insurer, Medibank, announced today that it will end its contract with the private hospitals operated by Calvary Health Care. Medibank has taken this decision after long-standing negotiations with the hospital group which was unable to agree to Medibank’s quality and affordability criteria.
Calvary Health Care has requested an increase in the rates Medibank pays for services provided to its members to a rate which Medibank considers to be unsustainable. Calvary Health Care was also unable to agree to a range of quality criteria Medibank requires of its contracted hospital providers.
Dr. Andrew Wilson, Medibank Executive General Manager of Provider Networks and Integrated Care, said that Medibank was committed to providing its members with access to quality private hospital services at reasonable prices.
“We believe it is essential, as a private health insurer, to encourage hospitals to maintain a focus on quality health outcomes for our members, including reducing re-admissions and avoiding preventable, adverse events,” said Dr. Wilson. “We also feel we have a responsibility to work with hospitals to help reduce unwarranted upward pressure on member premiums. We think it’s the right thing to do to ensure our members get the best quality care at an affordable and sustainable cost.”
Dr. Wilson continues, “It is disappointing that Calvary Health Care felt unable to agree to our affordability and quality requirements, which are part of our commitment to improving our members’ healthcare experience and maintaining the long-term affordability of healthcare. We remain open to working with Calvary Health Care through the auspices of the PHI Ombudsman to resolve this matter.”
Medibank and ahm members will continue to be covered under the terms of the existing contract with Calvary Health Care until this expires on 31 August 2015. Medibank and ahm members may still attend Calvary Health Care hospitals after this date and Medibank will continue to cover a large proportion of their costs. However, they may incur higher out-of-pocket costs because Calvary Health Care will be able to charge their own rates.
Medibank will contact members impacted by this decision. Members who are already receiving on-going treatment or who have pre-booked treatment before 31 August 2015 will continue to benefit from the existing contract terms for a transitional period.
“We would like to reassure our members that we contract more than 450 private hospitals across Australia providing members with real alternatives. We encourage Medibank and ahm members who may be affected to call Medibank on 132 331 or ahm on 134 246, or speak to their doctor to discuss their options,” Dr. Wilson said.
