Insurer bullying claims
PRIVATE hospitals are accusing health insurer Medibank of behaving like a bully and putting its shareholders ahead of patients.
Australian Private Hospitals Association chief executive Michael Roff says Medibank risks becoming an industry pariah, with hospitals concerned about the health fund’s “take it or leave it” approach to negotiations.
He says the issue is more widespread than Medibank’s highly publicised dispute with hospital operator Calvary.
The company was now putting shareholders ahead of members, Mr Roff said.
“Ultimately, that could be self-defeating if they end up losing members and therefore premium revenue, because of the approach that they’re taking,” he said. “It’s clear from the negotiation with Calvary that there’s the possibility that if patients stay with Medibank, they’re not going to be fully covered at their hospital of choice.”
Mr Roff said Medibank was trying to improve its profitability by refusing to pay hospitals, or pay a reduced benefit, for a list of 165 so-called “highly preventable adverse events”.
The list included infections in cancer patients who were undergoing treatment that left them vulnerable to infection, as well as bleeding and haemorrhage in patients with clotting disorders, Mr Roff said.