HEALTH consumers have welcomed a fast-tracked review of the medical complications which were a major stumbling block in negotiations between Medibank Private and Calvary Hospitals over recent months.
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The parties signed a new agreement after a lengthy stand-off when Medibank said it would no longer cover 165 "highly preventable adverse events" including injuries from falls in hospital and readmission for infections resulting from surgery.
Patient advocates had argued the change would unfairly impact older people and those who were frail due to other medical issues.
Consumer Health Forum chief executive Leanne Wells said patients had faced the prospect of paying hundreds of dollars extra for care on top of their private health insurance premiums.
She said more transparency was now needed on what would be covered under the new contract.
"Consumers pay thousands of dollars a year in health insurance premiums and the health fund is now a publicly listed for-profit company," she said.
"For all members know, Calvary may have weakened and agreed to 160 of the 165 preventable events - hardly a big win for consumers because differential costs will still fall to consumers.
"It's time to end the confidentiality which prevents consumers from getting a better insight into the cost and quality of care they are paying so much in insurance premiums for."
In September, Medibank announced it would consult with the Australian Commission on Safety and Quality in Health Care on what should be defined as preventable events, and would implement an independent clinical review process.
However the details of the new contract with Calvary, which runs 15 public and private hospitals nationally, remained confidential.
At the height of the furore, Australian Medical Association president Brian Owler put pressure on Health Minister Sussan Ley to intervene in what he said was a cost-cutting move by the major insurer.
He said doctors were concerned other insurers would follow Medibank's lead, placing enormous strain on the public and private hospital systems.
"We know that there will be patients that won't be able to be readmitted should they develop problems with their wound or other complications and they will have to go to public hospitals," he said.
"There are other patients that won't be able to afford the out of pocket expenses."
Medibank Private ran full page newspaper advertisements throughout the dispute, arguing that the Calvary group was declining to form a partnership to reduce "unfortunate" hospital mistakes.
"The primary objective of our approach has not been to save money - it is about preventing mistakes which are avoidable with the right focus and effort from everyone involved," Medibank executive general manager Dr Andrew Wilson said.
"These mistakes can cause significant grief to patients and the flow-on effects can be problematic to both the patient and the healthcare system."
