HCF pushes ahead with new partnerships while negotiations with Healthscope fail patients

Australia’s largest not-for-profit health fund HCF has announced two new multi-year agreements with leading private health care providers Healthe Care and Adventist HealthCare Limited (AHCL), along with an expansion of the services and benefits provided by long-term partner Ramsay Health Care all of which bolster choice in healthcare for HCF members.

This news comes shortly after disappointing negotiations between Healthscope and HCF which has led to their current agreement ending on January 31, 2023. Many patients are facing additional out-of-pocket expenses at Healthscope hospitals if they remain insured with HCF.

According to a company statement, Healthscope said “We have been challenged by health insurers not adequately funding the real and rising costs of our private hospital services, including rising interest rates, food, energy and power, insurance, nurse wages, PPE, maintenance and cleaning costs. These cost pressures have been well documented throughout the pandemic, and are now being exacerbated by the highest levels of inflation seen in decades.”

Australian Medical Association (AMA) President, Professor Steve Robson, said “The hard-ball negotiation tactics we have seen in recent months between hospital providers and insurers is another strong demonstration of why we need an independent Private Health System Authority, which could oversee or intervene in such processes.  

“It could also ensure a level playing field to keep our private health system working sustainably and retain patient choice and access high quality and affordable care.”

HCF Chief Executive Officer and Managing Director, Sheena Jack said the new partnerships with Healthe Care and Adventist HealthCare Limited will support the growth of all organisations involved by delivering long-term benefits to HCF members while also strengthening the sustainability of the private health care system in general.

“This is a big boost for our 1.8 million members and highlights our commitment to ensuring we provide them with access to the best services available by extending partnerships with private health care providers such as Sydney Adventist Hospital and HealtheCare hospitals,” Ms Jack said.

“By continuing access to these high-end facilities while adding a number of new services available to members at home during their treatment or while in recovery through Ramsay Health Care is an exciting prospect.”

The Healthe Care agreement extends the strategic partnership for the long-term, continuing access for HCF members to 17 facilities in regional NSW, Sydney, Melbourne and Tasmania including about 1,200 hospital beds and 70 operating theatres.

Healthe Care Chair, Ben Thynne said Healthe Care was proud to have strong relationships with its doctors, staff, suppliers and local communities.

“By working closely with funders like HCF over time we’re able to secure sustainable agreements as the industry tackles the many challenges that lie ahead, such as workforce shortages, and reforms to the private health sector in areas such as prostheses,” Mr Thynne said.

The new long-term agreement with the not-for-profit Sydney Adventist Hospital, operated by AHCL extends the strategic partnership by continuing to give members on the North Shore and surrounding areas access to one of Australia’s longest-running private facilities with more than 700 beds.

AHCL Chief Executive Officer, Brett Goods said he was very pleased to have collaborated with HCF to continue the strategic partnership for another five years and was certain that it would achieve significant benefits for HCF members and AHCL patients.

“Our strategic partnership has already achieved significant success and demonstrates our willingness to innovate. We’re looking forward to working with HCF to provide affordable access to excellent private health care for our patients. Our five-year agreement acknowledges the increased costs hospitals are facing and commits to explore further initiatives that will help to achieve affordability, better care and great outcomes for patients.

“The private health sector offers a highly valued choice for consumers and close partnerships with funders like HCF provide us with the opportunity to create more value for patients through new models of care, initiatives like gap-free orthopaedic surgery and more seamless transition to services like rehabilitation in the home,” Mr Goods said.

Building on the five-year collaboration agreed last year with Australia’s largest private hospital provider, Ramsay Health Care, HCF members will now be able to recover post-surgery in the comfort of their own homes through the Ramsay Connect program.

Ramsay Pharmacy CEO, Greg Kennedy said Ramsay was “committed to making quality health care more accessible and affordable for Australians and the new pharmacy discount program offers an opportunity for HCF members to access exclusive promotions and events, free samples and earn points towards cash rewards.”

“Creating these long-term partnerships provides benefits for all parties. Together we can focus on affordability and innovating new and exciting services for our members,” Ms Jack said.

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