SOME PRIVATE hospitals are resisting efforts by the VHI to reduce by 3 per cent the amount it pays them for all procedures next year.
The VHI also wants to put a monthly cap on the amount it pays each hospital for treating patients in 2011.
The State’s largest private health insurer gave hospitals until yesterday to sign up to the revised payments scheme. It is understood the majority refused to do so by last evening.
However, a spokesman for the St Vincent’s Healthcare Group, including St Vincent’s private hospital in Dublin, confirmed it had come to an agreement with the VHI on price reductions for next year. He confirmed its agreement included the 3 per cent cut and the cap. St Vincent’s private hospital is a not-for-profit facility.
Several other private hospitals, including the Beacon and Blackrock Clinic in Dublin, the Galway Clinic and the Bon Secours Hospital Group, which has hospitals in Dublin, Cork, Tralee and Galway, have not signed up to the revised arrangements.
Any hospital that fails to reach agreement with the VHI will be regarded as a “non-participating hospital”.
Patients with VHI cover could still use these hospitals but the VHI would only cover them for 75 per cent of the cost of their treatment.
The VHI also cut prices for procedures in private hospitals by 3 per cent last year and it cut the fees it pays hospital consultants by 15 per cent over the past two years. It is its proposal to cap payments to hospitals next year that has really angered the hospitals.
Dr Hubert Gallagher, a consultant urologist at the Beacon and Bon Secours hospitals in Dublin, said his concern was if monthly payments to hospitals were capped, hospitals would have to cap the number of patients treated.
This could result in some patients having treatment deferred or having to attend a public hospital if their condition required urgent treatment. If they went to public hospitals, he said, it would add to the “general chaos in emergency departments”.
He was also concerned the move could disrupt continuity of care to patients once a hospital met its monthly quota.
“They [the VHI] are increasing prices to subscribers and subscribers are now going to find services rationed,” he said. “If the VHI can’t fulfil their promises, they shouldn’t be taking subscriptions.”
In a statement, the VHI said negotiation with the hospitals were ongoing.
“There is plenty of private hospital capacity and most consultants operate in a number of hospitals and consequently we believe that our customers will continue to be able to access care.
“Should we fail to reach agreement with a hospital for 2011 any member who is in the middle of a treatment programme in hospital will continue to be covered.
“Some hospitals have very ambitious growth plans and VHI Healthcare is not in a position to fund these growth plans,” it added. “The proposals we have made to the hospitals do provide for an increase in revenue.”
It said the drive for efficiencies had to be seen against a backdrop of the VHI making underwriting losses of €160 million over the last three years. The number of insured persons had also fallen and its income had to meet its expenditure, it said.