Healix backs PMI open referrals

clock • 2 min read

Healix has voiced support for the use of open referrals within the private medical insurance (PMI) market but warned that insurers need to be more transparent about the process.

The healthcare trust provider denied claims that using open referrals restricted patient choice and could compromise quality of care.

However it noted that insurers risked alienating the important doctor-patient relationship if they only used cost as a reason to choose healthcare provider.

Bupa has been the most prominent insurer to use open referrals for patients requiring further treatment, but its decision has divided opinion among patients, brokers and doctors.

Sophina Gapare-Mburia, commercial manager of Healix Health Services, said that quality of care had to be the number one priority for any private healthcare provider but she did not believe this was being compromised by any of the recent initiatives introduced.

"However, what I think some of these organisations may not be focusing on - especially in helping potential clients and patients understand their approach - is the decision-making process to select the right healthcare provider for an individual," she said.

"Of course cost is an important consideration for our clients, but more often than not for employees, knowing more about clinical quality provided by their healthcare provider and knowing the available choices is just as important.

"And, in their view, this makes the entire process of choosing a provider a lot easier," she added.

Gapare-Mburia also recognised that disrupting the doctor-patient relationship with open referrals could be problematic and argued that the private healthcare market was "probably the toughest it has ever been".

"We recognise that the relationship between the patient and their healthcare provider is important," she continued.

"A one size fits all approach may not be suitable for everyone and this is why our nurses can offer individuals guidance on all providers who may be involved in their care, thus truly offering choice by giving them the responsibility of choosing their healthcare provider.

"For employers the need to continue to look after the health of their workforce remains high on their agenda.
"Getting the balance between commercial considerations and retaining a healthy workforce is, therefore, a challenge facing many organisations," she added.

More on PMI

General and Medical Healthcare joins amii
PMI

General and Medical Healthcare joins amii

PMI provider

Jaskeet Briah
clock 04 November 2024 • 1 min read
Benenden Health names Tom Woolgrove as CEO
PMI

Benenden Health names Tom Woolgrove as CEO

Former CII president

Jaskeet Briah
clock 29 October 2024 • 1 min read
Societal ageing and climate change adding to healthcare challenges
PMI

Societal ageing and climate change adding to healthcare challenges

AXA research shows

Jaskeet Briah
clock 14 October 2024 • 2 min read

Highlights

COVER Survey: Advisers damning of protection insurer service levels

COVER Survey: Advisers damning of protection insurer service levels

"It takes longer than ever to get underwriting terms"

John Brazier
clock 12 October 2023 • 5 min read
Online reviews trump price for young people selecting life and health cover

Online reviews trump price for young people selecting life and health cover

According to latest ReMark report

John Brazier
clock 11 October 2023 • 2 min read
ABI members with staff neurodiversity policy nearly doubles

ABI members with staff neurodiversity policy nearly doubles

Women within executive teams have grown to 32%

Jaskeet Briah
clock 10 October 2023 • 3 min read