Episodes of care in the private hospital sector increased by 2.6 percent for the July-September quarter in 2019, according to the latest data on private health insurance from the Australian Prudential Regulation Authority (APRA).
Private health insurance participation increased by 15,000, helping to offset a slight decline for the overall year.
“It is encouraging to see,” Mr Roff said.
However, he was concerned that nearly 60 percent of private health insurance policies still exclude certain services despite government reforms aimed at providing more inclusive cover.
“The risk is that Australians will find themselves in need of a procedure that their policy does not cover them for and will be unable to access the high-quality private hospital care they are relying on. Australians should check their policy regularly to ensure it is still fit for purpose,” Mr Roff said.
APRA reported that the number of privately-insured patients being treated in public hospitals is not increasing, but Mr Roff said it is still a significant problem.
“There are still way too many privately-insured patients treated in the public system. This is putting pressure on elective surgery waiting times in the public sector and means Australians who need the public system are left waiting for care,” he said.
The APRA data also revealed that, for the first time, health funds have subsidised more than 100 million services over the year to September 2019, with fewer than three percent of these incurring unknown out-of-pocket costs.
The funds paid out more than $21.4 billion in benefits over the same period – an annual increase of 3.6 percent – while the 2019 premium increase of 3.25 percent was the lowest in 18 years.
Private Healthcare Australia CEO Rachel David said though the government’s reforms had helped to deliver such benefits, other areas – such as the $250 million promised savings in the cost of medical devices, where insurance claims had actually increased by 8.3 percent in the past year – needed to be addressed.
Mr Roff said APHA will again be involved in the next round of government reforms, as it seeks to further improve the value of private health insurance, which is held by more than 11 million people – just over 44 percent of the population.
“As an industry we are actively working with government to implement solutions that will make a difference to Australians,” he said.