HCF releases highest hospital claims data for 2014
Sydney, 11 February 2015 - Australia’s largest not-for-profit private health insurer, HCF, has today released data detailing the highest hospital benefit payments made to members during 2014.
During last year, HCF funded almost 31,000 hospital admissions for which the benefit paid exceeded $10,000, with the hospital costs of these admissions coming to $623.5 million for the year.
Among notable claims handled by HCF:
- The highest individual claim paid was $297,000 for a 70 year old member who was treated for a brain tumour and spent 82 days in a NSW private hospital;
- Of HCF members aged 18-30 years, the highest individual claim was $84,000 for a 27 year old male in NSW who received treatment in a public hospital for psychiatric care;
- The highest payment for a public hospital was $110,000 for an episode of hospital care involving 168 days for a 59 year old male;
- There were 954 admissions where the hospital costs exceeded $50,000. Over a third of these admissions were cardiac procedures involving an Automatic Implantable Cardioverter Defibrillator (AICD). An AICD is a small device that's placed in the chest or abdomen. Doctors use the device to help treat irregular heartbeats called arrhythmias. It uses electrical pulses or shocks to help control life-threatening arrhythmias, especially those that can cause sudden cardiac arrest.
The growth in the use of devices such as the AICD is a strong example of how higher expectations, advances in medical technology and chronic disease are driving increased costs in private health. In 2004 only 7 AICD-related cardiac procedures were undertaken on HCF members per month but by 2009 the number had risen to 19. In 2014 these procedures had increased to 31 per month at a cost of more than $50,000 for each AICD device alone without taking into account related charges for hospital stay and specialist doctors.
HCF Medical Director, Dr Andrew Cottrill, said the claims data showed an increase in the highest hospital benefits paid during the year, highlighting the rising cost of hospital care.
“The number of hospital admissions funded by HCF, and the value of the highest hospital claims paid, continue to increase year on year,” he said.
“As a non-profit health insurer our priority is our members, not shareholders. HCF will always endeavour to deliver the best possible value to members, and that is reflected in the range of health cover products we offer tailored to different personal and family circumstances.”