What has happened?
After several months of negotiations, we have made the difficult decision not to re-contract with six health funds represented by the Australian Health Services Alliance (AHSA).
This decision was not taken lightly. But we need to ensure that our contracts with private health insurers reimburse us for the work our people do every day, and allow us to invest in
our facilities and equipment so we can continue to deliver world class care for patients.
Unfortunately, the rate offered for this two year agreement was simply not enough to allow our hospitals to meet their costs, such as paying the salaries of our nursing and other hospital staff, which was not something we could accept. It was also significantly out of step with what other health insurers pay.
The six funds are:
- Australian Unity
- Teachers Health Fund
- CUA Health Limited
- Reserve Bank Health Society Ltd
- CBHS Corporate Health Pty Ltd
- CBHS Health Fund Limited
We welcome all patients in ACHA hospitals and you can still be treated with us. Unfortunately, once the current agreements with these funds expire you may face some additional out of pocket costs. We remain willing to negotiate with the AHSA on behalf of these funds on a proposal that avoids this.
We have agreements in place with most major Australian health funds, including AAMI Health Insurance, AHM, Apia, Bupa, Cessnock District Health Fund, Grand United Corporate Health, HCF, IMAN Health Cover, Latrobe Health, Medibank, Mildura Health Fund, nib, Qantas Health Insurance and St.Lukes Health. While we cannot provide advice or recommendations around private health funds, Australia’s private health insurance regulations do allow members to move their cover to another health fund with no impact on waiting periods.
We welcome all patients in ACHA hospitals and you can still be treated with us. Unfortunately, once the current agreements with these funds expire you may face some additional out of pocket costs. We remain willing to negotiate with the AHSA on behalf of these funds on a proposal that avoids this.
Yes, Australia’s private health insurance regulations do allow members to move their cover to another health fund with no impact on waiting periods.
The Private Health Insurance Ombudsman has produced a guide for transferring your health insurance entitlements, which can be viewed at this link:
We would recommend you discuss this with your health fund directly on the numbers below:
In most cases, you will be covered under your fund’s existing contract with us for up to six months after the expiration of the contract. Please check with your ACHA hospital to confirm your specific situation.
Our hospitals are currently operating as part of the overall government response to COVID-19, a short term arrangement to ensure that Australia’s health system is as well prepared as possible with all available resources.
These arrangements cover most, but not all of our costs – we will not be profiting from these agreements. When these short term arrangements end, we need to ensure that our longer term agreements with health funds allow our hospitals to meet their costs, such as paying the salaries of our nursing and other hospital staff, and to invest in our facilities and equipment. The AHSA’s proposal will not do this.
Your health fund premium rose over 3 percent last year, but the rate your fund proposed to give ACHA the actual service provider is significantly less, and simply not enough to cover our costs.
We reject the Teachers Health Fund’s characterisation of the negotiations over rehabilitation services. The Fund was seeking a 50 per cent increase in rehabilitation treatment hours for their members with no additional reimbursement for this change.
We advised that we were not prepared to have our clinicians work extra hours at no charge.
Neither the proposed new hours, nor the fund’s previous span of hours represent any breach of treatment or clinical protocols, and we are disappointed the Teachers Health Fund would imply our doctors, nurses and clinicians provide anything less than outstanding patient care.
Our decision not to re-contract with the Teachers Health Fund is purely due to the fact that their proposal would not allow our hospitals to meet their costs both now and in the longer term. Today our nurses and other hospital staff are at the frontline of Australia’s COVID-19 response. Longer term, they will continue to provide world class care for patients and health insurers need to recognise and appropriately fund those efforts.