HCF Annual Report 2009

Review of Operations

HCF offers a range of products and services that provide the freedom for our members to choose and access high quality health care and financial services. We meet and exceed our members’ expectations through continued improvement in efficiency and service standards, meeting our pledge that HCF gives more for our members.

Hospital Care
Private Hospital Network

HCF negotiates charge agreements with private hospitals Australia-wide. They cover accommodation and other hospital-related services for members. We also have medical gap cover arrangements with specialists that cover the difference between their charge for in-hospital medical services and the Medicare Schedule Fee.

This ensures members will be fully covered for all hospital treatment or will incur an agreed excess, depending on their level of cover. HCF waives all excesses for all same day hospital care and for all overnight admissions resulting from accidents, a benefit not offered by most other funds.

Members who choose specialists participating in HCF’s medical gap scheme usually incur no out-of-pocket medical expenses.

We have charge agreements with 416 private hospitals and private same day hospitals which provided 98% of all private hospital admissions nationally and 99% of all private hospital admissions in NSW and the ACT this year. HCF contracts only with private hospitals which are fully accredited by official bodies such as the Australian Council of Healthcare Standards, an independent organisation dedicated to improving the quality of health care through performance assessment and accreditation.

Medical Gap Coverage
HCF has 22,900 specialist doctors participating in our Medical Gap Cover scheme. During 2008/09 we fully covered 87% of all hospital related medical services provided to HCF members, the same as last year, and above the industry average of 85%. 81% of all medical services provided to Manchester Unity hospital patients were fully covered. HCF is in the course of replacing previous MU ‘gap’ cover arrangements with those applying to HCF members. We expect this will increase the gap coverage ratio to the same as HCF members’ experience.

Prosthesis Benefits
Charges for prostheses are negotiated on an industry basis by the Prostheses and Devices Negotiating Group. HCF benefits paid for prostheses increased by $12.3 million (14%) in 2008/09 to $99.9 million. The growth in the number and cost of prostheses reflects higher usage, ageing of the insured population, improved technology and changes in medical practice. MU prosthesis benefits were $13.4 million.