[et_pb_section fb_built=”1″ admin_label=”!!! PLEASE DO NOT EDIT !!!” _builder_version=”4.19.5″ _module_preset=”default” global_colors_info=”{}”][et_pb_row admin_label=”!!! PLEASE DO NOT EDIT !!!” _builder_version=”4.19.5″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.19.5″ _module_preset=”default” global_colors_info=”{}”][et_pb_text admin_label=”TO BE EDITED – SUMMARY – Click on the WHEEL icon to open the textarea where you can paste or type your summary. The summary condenses the main points for the news that starts below. The summary is in bold and not longer than 300 characters, including spaces. The counter at the bottom can help.” _builder_version=”4.21.0″ _module_preset=”default” custom_padding=”||20px||false|false” global_colors_info=”{}”]<\/p>\n
Australia\u2019s private hospitals allege major insurers use unfair contract practices that hurt patient care and threaten hospital viability; insurers deny wrongdoing. Government is considering regulatory action as tensions disrupt private healthcare sector.<\/strong><\/p>\n<\/div>\n [\/et_pb_text][et_pb_text admin_label=”TO BE EDITED – TEXT OF THE NEWS – BLOCK 1 – Click on the WHEEL icon to open the textarea where you can paste or type your news. PLEASE USE ONLY THE FEATURED IMAGE FUNCTION on your right column to add the image.” _builder_version=”4.21.0″ _module_preset=”default” custom_padding=”||1em||false|false” global_colors_info=”{}”]<\/p>\n Australia\u2019s private hospital sector is embroiled in a deepening conflict with health insurers, with the Australian Private Hospitals Association accusing major insurers of \u201cunfair and unconscionable\u201d practices that compromise patient care and threaten the viability of private healthcare. Brett Heffernan, the association\u2019s chief executive, has written to Prime Minister Anthony Albanese outlining allegations that insurance companies are abusing their market dominance for profit, forcing hospitals into unfavourable contracts, and negatively affecting both patient choice and care quality. Heffernan claims many private hospitals are near collapse, pointing to the shutdown of provider Healthscope and the closure of more than 70 smaller private hospital operations since 2020, all due to financial distress allegedly caused by insurer behavior.<\/p>\n The association\u2019s grievances center on the insurers\u2019 contracting practices, including delays in negotiating new hospital contracts which leave facilities operating on outdated, lower prices. According to Heffernan, insurers often present \u201ctake it or leave it\u201d contract terms, erasing hospitals\u2019 ability to negotiate and contributing to declining service standards for insured Australians, who now receive less choice, reduced access and compromised care despite maintaining their insurance. Rachel David, CEO of the peak body for private health insurers, has firmly denied these allegations, arguing that tough negotiations are essential to control rising premium costs, although she conceded that the contracting process needs review.<\/p>\n A particularly contentious issue is the system of bundled payments, which group payments for various care elements\u2014including rehabilitation\u2014into one sum. The hospital association contends this results in limits on rehab benefits for patients, with hospitals pressured to discharge patients before necessary rehabilitation is completed, contradicting doctors\u2019 recommendations. Some clinicians, like orthopaedic surgeon Roger Brighton, say this undermines clinical judgment and patient outcomes. Heffernan warned that this approach resembles US-style \u201cmanaged care,\u201d where insurance companies predetermine the extent of treatment. David responded that bundled payments aim to ensure continuity of care and improved outcomes, but acknowledged unresolved challenges that the Private Health CEO Forum\u2014a government-convened panel of industry experts\u2014is attempting to address.<\/p>\n The toxic relationship between insurers and private hospitals creates uncertainty for patients, with both sides accusing one another of non-transparency and self-serving conduct. The federal government last year intervened by requesting hospitals to disclose their financials, a response to the sector\u2019s growing instability. Experts like Peter Breadon from the Grattan Institute say the conflict has become dysfunctional, with deteriorating trust and ongoing disputes risking patients\u2019 ability to access care. Breadon suggested that adopting an activity-based funding model, similar to public hospitals, could help address funding fairness. Heffernan advocates for a mandatory, enforceable Code of Conduct\u2014backed by regulatory oversight and penalties\u2014while David maintains that current regulations are already stringent, and additional rules are unnecessary. The federal government prefers the sector to find collaborative solutions, but signals willingness to regulate if required, as the future of Australia\u2019s private hospital system hangs in the balance.<\/p>\n<\/div>\n [\/et_pb_text][et_pb_text admin_label=”TO BE EDITED – TEXT OF THE NEWS – BLOCK 2 – Click on the WHEEL icon to open the textarea where you can paste or type your news. PLEASE USE ONLY THE FEATURED IMAGE FUNCTION on your right column to add the image.” _builder_version=”4.21.0″ _module_preset=”default” global_colors_info=”{}”][\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":" Australia\u2019s private hospitals allege major insurers use unfair contract practices that hurt patient care and threaten hospital viability; insurers deny wrongdoing. Government is considering regulatory action as tensions disrupt private healthcare sector. Australia\u2019s private hospital sector is embroiled in a deepening conflict with health insurers, with the Australian Private Hospitals Association accusing major insurers of…<\/p>\n","protected":false},"author":2098,"featured_media":987783418,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":""},"categories":[],"tags":[134,130,132],"acf":[],"_links":{"self":[{"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/news\/987783415"}],"collection":[{"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/news"}],"about":[{"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/types\/news"}],"author":[{"embeddable":true,"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/users\/2098"}],"replies":[{"embeddable":true,"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/comments?post=987783415"}],"version-history":[{"count":4,"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/news\/987783415\/revisions"}],"predecessor-version":[{"id":987783424,"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/news\/987783415\/revisions\/987783424"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/media\/987783418"}],"wp:attachment":[{"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/media?parent=987783415"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/categories?post=987783415"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/tags?post=987783415"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}