Transparency for out-of-pocket medical costs

Richard Laycock 6 March 2019 NEWS

Doctor speaking with patient

Government website to eliminate medical "bill shock" for consumers.

In what will come as welcome news to many Australians, the government has announced a new website that will provide clarity around out-of-pocket fees charged by specialists.

The announcement follows the release of the Ministerial Advisory Committee on Out of Pocket Costs report, which found that while most doctors disclose the costs of treatment appropriately there was a minority of medical specialists that charged unexpected out-of-pocket costs.

"This practice can cause enormous distress and financial hardship for patients and their families. It also undermines Australia's private health insurance system," Minister for health Greg Hunt said in a statement.

The new website will expect that specialists "show their fees as agreed with the medical profession", which should help consumers and their referring GPs make better and more informed treatment decisions.

The Australian Medical Association (AMA) welcomed the news saying that it wants full transparency and condemns "egregious billing". However, it did have some questions over the extent of this transparency.

" ... transparency must extend to both the size of the MBS rebate and the private health insurance contribution to the cost of treatment. While it appears that this website will include information about MBS rebates, will it show the specific rebate for a given procedure, or just the average out-of-pocket cost in tiers?" AMA president Dr Tony Bartone asked in a prepared release.

HCF CEO Sheena Jack also welcomed the initiative, saying that confusion around out-of-pocket costs was one of the catalysts for why HCF launched a similar site for its members.

"Our own research shows fees can vary widely between medical specialists and it is difficult for consumers to make informed decisions when selecting healthcare providers," Jack said in a statement.

Private Healthcare Australia (PHA) and the Department of Health have also been conducting their own research into out-of-pocket costs in Australia over the last two years. The results showed that roughly 40% saw a gap charged at an average of $1,000.

"The research found that the average size of the gap by specialist varies considerably. While the largest proportion of gaps falls in the range of less than $500, one in five (19%) are greater than $2,000 and one in fifty (2%) exceed $10,000. The largest gap recorded was $40,000," a statement from PHA chief executive Dr Rachel David read.

The news follows similar calls from National Seniors Australia, which last week found that seniors were worried about the out-of-pocket costs for services and procedures under their private health insurance and Medicare.

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