MTAA rejects ‘misinformation’ asserted by Private Healthcare Australia

MedTech & Diagnostics News: The Medical Technology Association of Australia (MTAA) has firmly rejected Private Healthcare Australia’s (PHA) “shared misinformation” regarding medical devices, in a perspective piece published recently.

The medtech industry body pushed back on the insurance lobby’s claim that the current policy settings governing the Prescribed List (PL) is resulting in “low-value care”.

The collaborative work conducted by the Royal Australasian College of Surgeons (RACS) NSW, Surgical Services Taskforce NSW and the Agency for Clinical Innovation NSW, explains that “Value-driven care is often mistaken for cost reduction. While cost considerations are part of the framework, avoidance of low-value care is multifaceted – derived from improving health outcomes and patient experiences as well as efficient and sustainable deployment of healthcare resources.”

Despite this, Dr Rachel David, CEO of PHA referred to a narrow and perhaps unjustified set of factors contributing to low-value care that include “deficiencies in regulating the Prescribed List (PL), gaps in ensuring the quality and safety of medical devices, and the influence of marketing strategies and conflicts of interest.”

MTAA CEO, Ian Burgess, said “MedTech companies have delivered a 14% decrease since 2017 for average benefits paid for medical devices and generated $2.3 billion in savings during this same time. Insurers have failed to pass on these savings, in full, to their policyholders.”

The surgeons contributing to the collaborative work mentioned earlier noted that the “assessment of low-value care should include a whole of system assessment of the patient’s journey, ensuring that the right care is provided in the right way using the right resources. This includes assessing patient’s needs, proficiency of the system, process support, procedure choice and procurement efficiency.”

MTAA told Health Industry Hub that the organisation is committed to “working together with all stakeholders, including Private Health Australia, in a constructive manner to bring about the best possible outcomes for patients”. To facilitate this, MTAA is calling upon PHA to acknowledge the importance of insurers in delivering “true value to policyholders”, and to engage in discussions with the sector on delivering sustainable access to medical devices to protect the patient access and doctor choice guarantee of the PL. 

Data from the Australian Prudential Regulation Authority (APRA) shows that the proportion that health insurers pay for medical devices has declined over the last decade, while their management expenses have increased by 90% between 2013 and 2023. Meanwhile, private health insurers have seen their management expenses and fees climb during a cost-of-living crisis – up from $2.1bn to $3bn between 2016 and 2022.

“At a time when Australians are making tough decisions about how to balance their expenses, it is critical that all players within the health system ensure they’re offering value for money,” reiterated Mr Burgess. “With health insurers receiving $7 billion in taxpayer subsidies there is an onus of responsibility on insurers to control their management costs and offer better value.” 

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