Consultants may face lower pay from VHI over delays

HOSPITAL CONSULTANTS could face lower levels of payments from VHI if there are undue delays in discharging patients from hospitals, under a proposed new fee agreement put forward by the State-owned health insurer.

However, the company said there would not be a general reduction in professional fees paid to consultants under the revised deal.

VHI said it would build in rules to its reimbursement arrangements with the aim of reducing the length of stay for patients in hospitals and to encourage speedy provision of diagnostic services.

VHI said it would “focus on incentivising timely reporting of radiology and pathology investigations and consultations, the aim of which is shortening the hospital length of stay for the patient”.

“The main aim is to bring about efficiencies, particularly to ensure that diagnostic tests and consultant consultations are reported to the attending consultant without delay,” the VHI added in a statement.

“Our IT systems are well placed to ensure we can capture the data necessary to monitor the provision of these services to patients in the in-hospital setting. If undue delays occur then there will be consequences in lower benefits for the consultants involved.

“As a result of this initiative, there will not be a general reduction in professional fee rates published in the schedule of benefits for professional fees for this agreement period.”

VHI said its initiative had the potential to bring about savings of around €40 million if the length of stay for patients in hospitals was reduced by one- two days on average over the two-year period of the proposed new agreement.

“In the current round of discussions with consultants, VHI Healthcare’s aim was to build into its reimbursement mechanism a system that rewards the delivery of care to a patient in the most efficient, effective and timely fashion commensurate with high-quality healthcare.

“Length of stay is widely acknowledged as the primary driver of hospital cost. In essence, managing length of stay is the key to achieving a more cost-effective healthcare system.

“Clinicians have an important role to play in implementing changes in the way that healthcare is delivered and in this regard VHI Healthcare must play its part ensuring that our benefit structures reward the increased intensity of services provided within a shorter time frame.

“The previous agreement between VHI and consultants on fees expired at the end of June.”

VHI has already put in place cumulative cuts of about 15 per cent in fees paid to consultants over recent years.

Last summer, it emerged that one hospital consultant had received more than €1 million in fees from the VHI in 2010, a move criticised by the Minister for Health, James Reilly.