The Private Healthcare Information Network (PHIN) plans to implement a new approach to publishing consultant fee arrangements via its portal next year which will help the private medical insurance (PMI) sector.
However it warned private practitioners that support from the Competition and Markets Authority (CMA) to enforce compliance may be brought in, noting that achieving wide coverage for the approach may take some time.
And the body added it will also develop a solution for publishing insurer fee arrangements on its website next year.
PHIN’s research showed patients prioritised understanding if a consultant fee was likely to be met in full by their private healthcare insurer rather than understanding the price itself.
Consequently, PHIN began a project to identify and implement a process where consultants indicate their charging behaviour in respect of patients insured with larger PMI providers.
PHIN revealed that while the project was delayed during the pandemic, it is now near to a solution which has been tested with consultants and PMI providers.
It now plans to implement the fee arrangements approach via the consultant portal early in 2023 and begin collecting the required information from consultants.
PHIN also expects to reach an agreed solution for the collection and publication of anaesthetic fees by the end of 2024.
The details feature in the PHIN’s roadmap and delivery plan for 2022-2026 outlining how it will fulfil the CMA order from 2014 to increase transparency in the sector and empower customers.
The roadmap also reveals private medical insurers have demanded healthcare providers including hospital groups and clinicians speed up compliance with requirements to publish data about patient outcomes and practitioner fees.
Self-pay data to follow
As part of the overhaul, PHIN said it will continue to improve the process for consultants to submit consultation and procedure fees via its portal.
This includes amending its portal fee submission process to enable consultants who only offer outpatient services to input their consultation fees.
PHIN also expects it will take a further year before anaesthetic fees have been collected at scale and can be published alongside surgeons’ fees on the website.
According to the plan, stakeholders in the sector said they recognised that publishing consultant fees provides only a partial understanding of the cost of private treatment.
The document added that providing patients with comparable hospital self-pay package prices, while not within the CMA order, will be of huge benefit to patients and there are proposals to reconsider this with the sector once the obligations in Article 21 and 22 of the CMA Order are delivered, but not before then.
The CMA’s order also specifies that consultants’ practice fees terms and conditions should be made available and published for patients which will need to built into fee initiatives over the course of the plan.
For more on the plan: ‘Step-change’ needed as private healthcare ‘long way’ off data compliance – PHIN – Health & Protection (healthcareandprotection.com), CMA increases oversight and criticises private healthcare providers for delays to publishing fee and outcome data – Health & Protection (healthcareandprotection.com)