Putting members’ health before profit

Demand for private health care services rebounds

Signs of a return to capacity in Australia’s hospitals are quickly re-emerging as patient demand for consultations and treatments rapidly bounce back to pre-COVID levels, new research shows.

A study by Members Health, the peak body for 27 not-for-profit or member owned funds representing approximately 30 per cent market share or around 3.7 million insured Australians, shows eligibility checks – a lead indicator of hospital referrals from specialist consultations – have returned to 98 per cent of pre-COVID levels.

“This means people are booking back in for important elective surgeries, treatments and check-ups that they had to delay due to the shutdown measures,” said Members Health CEO Matthew Koce.

“Based on those trends, it is expected that demand for services will have already surpassed 100 per cent.”

Eligibility checks for cancer treatments, heart and vascular system procedures, pregnancy, psychiatric and bone, joint and muscle procedures all recovered to well over 100 per cent by June 13, according to the study, which collated data from Members Health funds and was prepared by expert actuaries.

Private patient eligibility checks dipped to 50 per cent of pre-COVID levels during the height of the elective surgery slowdown, between March 21 and June 13. However, the data also shows that vital care that cannot be delayed, such as pregnancy, never stopped.

“Health funds were covering their members throughout the pandemic for a many urgent and lifesaving procedures, including important cancer treatments like chemotherapy and immunotherapy, mental health and psychiatric services,” Mr Koce said.

“Australia’s private hospitals are among the best in the world. Nurses, doctors and specialists have been working very hard to keep the flow of services during the pandemic to ensure Australians still get access to important treatments.”

“The private system is an important pressure valve for the public system, especially during a pandemic like COVID-19. With patient demand back up to around 100 per cent, private hospitals and their staff will be working around the clock to make sure private patients receive the fastest available access to high quality care when they need it.”

Prior to the COVID-19 slowdown, public hospitals had seen consistent annual increases in the length of time and volume of people put on waiting lists for important elective surgeries. Analysts have predicted these public hospital wait times could balloon much further post COVID-19 – even up to two years for some surgical specialities.

Andrew Goodsall, senior healthcare analyst with MST Marquee, said data in one state had already confirmed that 97 per cent of all public Category 3 elective surgeries – for conditions that cause pain, dysfunction or disability but are unlikely to deteriorate quickly, do not have the potential to become an emergency and require admission within 365 days – were cancelled during COVID-19.

“This is consistent with our estimate of around 107,000 surgeries that were missed in public hospitals nationwide since March,” Mr Goodsall said.

“Consistent with other analysis, it is estimated that the backlog in public elective surgery waiting lists will likely take in excess of a year to clear.”

“Early data from one state already confirms a significant 17 per cent increase in the number of semi-urgent public elective surgeries waiting more than the recommended time.”

Members Health is the peak industry body for an alliance of 27 health funds that are not-for-profit or part of a member-owned group, region or community. They all share the common ethic of putting their members’ health before profit and represent the interests of more than 3.7 million Australians.

Download the full press release and supporting data 


Media enquiries:

Jodie Harrison    0425 754 370    jodie@theshannoncompany.com.au

Eddie Morton      0499 700 295   Eddie.Morton@membershealth.com.au