Private hospital provider Calvary Health Care is warning Tasmanian Medibank customers they will pay more for medical services if the insurer terminates its contract with the health service.
After lengthy contract negotiations between Medibank Private and Calvary, the insurer announced a fortnight ago it would terminate the contract at the end of August.
Medibank presented Calvary with a list of 165 “highly preventable adverse events” that it would no longer pay for.
It also said it would not cover unplanned re-admissions in a 28-day period unless the patient had a chronic illness or was terminally ill.
Medibank said it had successfully negotiated contracts under similar terms with other providers, but Calvary had been unable to agree.
Calvary treats about 60 per cent of Tasmania’s private hospital patients, and about a quarter of those are Medibank members.
Calvary’s national chief executive, Mark Doran, said patients who were Medibank members would have to pay more at Calvary’s hospitals around the state from September if the contract was terminated.
He said he hoped patients would be able to see the benefit in continuing to choose Calvary’s services over other providers.
“We’d hope that they see that what we’re offering is of value and that the out-of-pocket expense is a reasonable proposition for them,” he said.
Mr Doran said the other option would be for patients to consider changing insurer.
“We would suggest that they look hard at what other options are available with other funders,” Mr Doran said.
The two parties will hold mediated talks with the Private Health Insurance Ombudsman next week.
Medibank confident of a satisfactory agreement
Medibank’s senior medical advisor, Ian Boyd, said he was still hopeful an agreement would be reached with Calvary, but if members had concerns they should get in contact.
“We are happy to talk to them and deal with any specific concerns they have about, perhaps, upcoming or planned admissions that they have to Calvary hospitals, and we’ll be certainly contacting members proactively to do that,” he said.
“We’re confident that we can reach a satisfactory conclusion.
“However, we remain steadfast in our resolve to include safety and quality and clinical outcome elements in the contract.
“That is a sticking point, or a point of concern for Calvary, but we remain wedded to that.”
Mr Boyd said that even if the contract was terminated, Medibank members would have the majority of their costs covered.