Aviva has launched a new Private MedicaI Insurance (PMI) product, Guidewell, with an open referral pathway for large corporate schemes.
It promises no shortfall on hospital charges or specialist fees and has been developed to meet demand by corporate clients to manage the rising cost of claims and control healthcare spend.
Open referral, also offered by Bupa and AXA PPP, is a recommendation by a GP for a medical investigation or treatment, without the GP being specific about which specialist or hospital carries out the procedure.
Aviva said the product's development was informed by Competition Commission research into PMI patients' views of the referral process.
When choosing a hospital, the single most important factor for PMI patients is location (50%) followed by whether the fees and charges will be fully covered by their policy (39%), the research found.
Aviva said under the new plan, generally employees can expect an appointment within a 20 mile radius of their postcode outside of Central London, or 10 miles within.
However, where multiple specialists could equally undertake the appointment, a single choice of specialist will be given.
Employees with more complex conditions such as cancer, heart, women's health and psychiatric conditions are to be provided with a dedicated case manager experienced in their condition.
Any musculoskeletal problems will be managed through Aviva's BacktoBetter rehabilitation service. Employees can also access a 24-hour GP helpline, stress counselling helpline, gym discounts, Aviva's Home of Health portal and a mobile Stress App. In addition, members are eligible for up to 15% discount on Aviva's motor, home and travel insurance.
Dr Doug Wright, medical director at Aviva, UK Health, said: "As open referral helps manage costs as well as quality, it means that some large companies will benefit from competitive pricing upfront, making the provision of this employee benefit much more sustainable over time.
"We have already seen an increase in the use of open referral in our PMI claims, with more GPs and customers choosing this route for their diagnosis and care. When managed properly, open referral is a great way for employers to regulate their costs and for employees to access prompt, local treatment by recognised specialists and hospitals."
