Private medical insurers are pressurising patients over costs and affecting patient choice, a survey of consultants suggests.
Ninety seven percent of respondents said these cost pressures were lowering choice and damaging continuity of care. Consultants were surveyed by the Federation of Independent Practitioner Organisations (FIPO) to identify how the patient-consultant-insurer relationship is being affected by the growth of fixed fee schedules.
Introduced by AXA PPP Healthcare in 2008, the schedule has resulted in some higher-charging consultants not being recognised by the insurer.
FIPO claims patients referred by their GP to a preferred specialist may be told by AXA PPP that their consultant of choice could overcharge and they should see another, cheaper, ‘recommended’ consultant. If patients still opt to see their first choice consultant, their reimbursements could be reduced.
Ninety eight percent of respondents felt that an insurance strategy like this is inspired by commercial considerations rather than quality considerations. The survey also suggests that AXA PPP is targeting 20% of consultants.
Mr Geoffrey Glazer, chairman of FIPO, said: “Almost a quarter of all consultants can cite instances where insurers have suggested referral of patients to an alternative consultant for cost considerations.
“This can destroy continuity of care as first choice consultants may already know the patient well and thus have a better understanding of the patient’s medical condition than a new specialist. This insurance tactic also undermines the long established referral pathway between GP and consultant as well as the patient-doctor relationship and places unnecessary pressure on patients who are sick, vulnerable and in need of medical care.”
The survey also shows incidents where private medical insurers have forced patients to undergo procedures in certain hospitals which may not be the best equipped or most convenient for them.
And patients have also been redirected to consultants who, while they may be of the same generic specialty, are not subspecialists able to deal with patient-specific needs.
Dr Simon Peck, head of provider audit and information at AXA PPP healthcare, said quality was the insurers “number one consideration”.
He said: “We offer our customers a wide range of choices. We have products where customers can receive a full refund of fees in any hospital in the UK, and we also offer various options whereby customers can obtain insurance at lesser rates, for example by agreeing to use our preferred provider network.
“FIPO appear to be confusing the issue of doctors’ personal fees with the issue of clinical quality. We do not believe there is any correlation between the level of fees charged and the quality of services provided. There are some doctors whose fee expectations are not commercially realistic. In general, our policies cover the vast majority of specialists’ fees in full.”
The survey was completed by 730 consultants.
Tags: Ins, Private practice
