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January 24, 2017


Medibank’s latest Health Cost and Utilisation Report, for the 2016 financial year, shows substantial increases in admissions and the benefits Medibank paid out on behalf of customers.

Of the top 10 highest benefits paid for hospital care, six were for neonatal, with the largest single hospital claim of more than $430,000 for the care of a newborn infant.

Medibank has increased the amount paid for many common hospital visits in recent years, including for childbirth, rehab, and joint surgeries, as healthcare costs rise.

Chief Medical Officer Dr Linda Swan said despite rising costs, Medibank is finding ways to improve its products.

“Last year we added accident coverage for all customers with hospital products, and unlimited emergency ambulance for all customers. We also gave Medibank extras customers a 100 per cent back dental check up on top of their existing limits,” Dr Swan said.

“As healthcare costs and hospital admissions rise, this Health Cost and Utilisation Report is a snapshot of our biggest and most common hospital claims.”

Childbirth, rehab, joint replacements and shoulder procedures topped the list of Medibank’s most commonly claimed surgeries, with knee replacements up by 11 per cent in the last four years and inpatient rehab admissions up by 15 per cent in the same period.

The five most common same-day hospital services were colonoscopies, chemotherapy, dialysis, rehab and cataract procedures. In the last four years, chemotherapy admissions increased eight per cent and cataract procedures increased seven per cent.

Dr Swan said out-of-pocket costs remained a concern for many private health customers, but it was important to know they had a choice of surgeon or specialist with private care.

“In many cases, we are paying for our customers’ healthcare at rates that are well above the fees set by the Government’s Medicare Benefits Schedule,” Dr Swan said.

“It’s important to discuss potential out-of-pocket charges with your surgeon or specialist, as providers can charge very different out-of-pocket costs and many don’t charge extra fees at all.”

Increases in admissions for inpatient rehab, hip replacements, and knee replacements pointed to the trend of a growing number of Australians suffering osteoarthritis or other musculoskeletal conditions.

“To try and improve the outlook for the 1.9 million Australian osteoarthritis sufferers, we have launched the Medibank Better Health Foundation to increase research funding for musculoskeletal conditions,” Dr Swan said.

“If we can assist researchers in promoting and implementing better management tools and treatments for osteoarthritis, we can substantially improve the outlook for the one in 12 Australians who suffer from the condition.”

Media enquiries: Bronwyn Perry - 0438 545 090 /

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