What has happened?
Despite extensive efforts, Healthscope has been unable to agree fair commercial terms with the health funds which are members of the Australian Health Service Alliance (AHSA). The funds which are part of the AHSA are listed here: https://ahsa.au/our-funds/
In late November 2024, we gave AHSA health funds notice that our contract with them will terminate. What this means is that we are now in a notice period and the health fund contract continues to apply. There are no immediate impacts for patients at our hospitals.
We are trying to agree a new contract with the AHSA which means their fund members don’t have to pay additional fees for treatment in our hospitals.
We are aware of the impact this is likely to have for our patients who are AHSA health fund members. The last thing we want to do is impose any additional costs on patients during a cost of living crisis. We remain ready to work with the AHSA to reach an agreement that sustainably funds our hospitals.
Healthscope has agreements with four of Australia’s five major insurance groups (Bupa, Medibank, NIB and HCF).
Why has this happened?
Healthscope and the rest of the private health sector continue to face significant financial challenges and increasing costs. There are a number of reasons for this, including the fact that many private health insurers are not funding hospitals fairly and sustainably.
Unfortunately, the AHSA health funds were not offering funding that is sufficient for Healthscope to sustainably offer quality health care going forward, so we gave them notice that our contracts with them will terminate.
This is a disappointing outcome, and certainly not our preferred option. It is an unprecedented step, but something has to change to secure the future of private hospitals. The only long-term solution is an industry solution, with hospitals, governments and doctors forcing private health insurance companies to appropriately fund the cost of patient care. We remain ready to work with the AHSA to reach an agreement that sustainably funds our hospitals.
This issue only affects AHSA health fund members. Patients who are members of other funds are not impacted. Healthscope has agreements in place with other major Australian health insurers including Bupa, HCF, Medibank and NIB.
Who is communicating this to my patients who are AHSA health fund members?
The AHSA are responsible for advising their members that they will be out of contract with Healthscope unless a new agreement can be negotiated. VMOs should advise their patients who want more information to contact their specific AHSA fund (visit https://ahsa.au/our-funds/ for details).
Healthscope has created a webpage for patients and VMOs who would like more information, including how to change health funds if they choose to: https://healthscope.com.au/Faircare
We are also providing support for patients by responding to any queries we receive, as well as providing information and updates for our hospital staff and VMOs.
Which funds are affected?
Do you expect me to tell my patients about the impact on them of this?
Healthscope has communicated to all pre-booked patients who are members of AHSA health funds. It is your choice as to how you tell your patients about this situation. We have provided you with a letter explaining the situation that you or your practice manager can share with your impacted patients to help them make an informed choice.
