Bupa has become the first major private health insurer to introduce a new funding model for hospitals across Australia encompassing nearly 500 medical consumable items crucial for everyday surgeries, such as glues, sponges, staples, and catheters.
The move aims to bring increased predictability to hospitals and drive down healthcare costs for Bupa's members.
Australia has grappled with some of the world's highest prices for medical devices and surgical products within the realm of private health insurance, exceeding costs in similar countries by approximately $967 million, according to Bupa. This financial burden is borne by Australians with private health coverage and is dictated by the Prescribed List of Medical Devices and Tissue Products, previously known as the Prostheses List.
The Prescribed List is utilised by the federal government to set prices for medical devices and tissue products for private patients in Australia, bypassing competitive processes or international benchmarks.
Bupa has been actively supporting the federal government's move to remove these 500 items from the list, which enables health insurers and hospitals to engage in collaborative negotiations, steering clear of the impact of excessive markups by device companies.
Bupa managing director Chris Carroll said the reforms are geared towards ensuring the sustainability of Australia's renowned healthcare system.
“These changes are about ensuring our members have access to affordable care. I'm pleased we're leading the private health industry in taking steps in this area and working together with hospitals to offer customer-centred care and value,” he said. “We've worked collaboratively with hospitals on a new proposed funding model that takes into account hospital costs while protecting our health system from inflated prices which are then passed onto patients.
“With ongoing cost-of-living pressures, we will continue to push for reforms to help keep premiums affordable and sustainable including advocating for fairer medical device pricing.”
Bupa's innovative funding arrangements, utilising existing billing codes, will be universally applicable to all hospitals. The simplicity of implementation, without the need for expensive software updates, provides hospitals with a six-month lead time, ensuring certainty before the items are delisted from the Prescribed List on July 1, 2024.
In other news, Bupa officially transitioned to renewable energy in the APAC region.
