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Bupa pledges to drive quality and control premium costs 20 October 2005 Bupa Insurance is launching three new initiatives in its drive to deliver quality and clinical excellence for its members, control costs and make private medical insurance (pmi) more affordable. The initiatives include speciality based contracting, a new schedule of procedures and an enhanced consultant recognition programme. Speciality based contractingFollowing the successful establishment of Bupa’s accredited breast, bowel and gynaecological cancer units, Bupa is developing an MRI speciality network offering providers the opportunity to become part of a quality-based network of MRI facilities for out-patient services. Patients will benefit from scans and results within 48 hours and ongoing audits will ensure the accuracy of reports. Successful providers will be able to demonstrate that they can meet explicit quality standards and work with Bupa to optimise service efficiency. Dr Natalie-Jane Macdonald, Bupa’s medical director, said: "Bupa is the only medical insurer in the UK to offer customers a nationally accredited network of private and NHS hospitals where cancer patients can be guaranteed to receive the right cancer treatment from specialist teams. This gives them the highest chances of a cure. By extending this concept, firstly to MRI scans, we aim to continue raising standards, while maintaining control of our costs and therefore reducing the impact on premiums." New Bupa Schedule of ProceduresIn January 2006 Bupa, along with other medical insurers, will implement the new Schedule of Procedures developed by the Clinical Classification and Schedule Development (CCSD) Group.* In addition to the new CCSD codes and narratives, Bupa will launch a new Schedule which will include consultants’ fees along with data on target lengths of stay for a number of commonly performed procedures and details of procedures that can usually be carried out on a day-case basis. Dr Natalie-Jane Macdonald explained: "Bupa’s position on consultants’ fees and the classification of procedures within the new Schedule is likely to be met with great interest amongst the independent sector as a whole. Reluctantly, we have concluded that we cannot use the new Schedule to introduce widespread changes to consultants’ fees. "To reward at a higher level those procedures worthy of increased reimbursement would mean reductions for those procedures that have become quicker and simpler over time. “We are not convinced that consultants would accept this approach and the consequence would have been higher shortfalls for patients. Instead, we will focus our efforts on working with consultants and hospitals to improve the efficiency and quality of care and look to share the resulting benefits with both groups," she said. Consultant RecognitionOver the next 12 months, Bupa will be contacting consultants to discuss their specialisms and clinical practice to ensure its recognition arrangements reflect the general move towards specialisation by consultants. This will also be invaluable to Bupa in providing information to Bupa members, who are increasingly asking for information about their treatment and their doctors. Dr Natalie-Jane Macdonald comments: "We are confident that, through working in partnership with consultants and hospitals, we can continue to give our members a service that is second to none, while successfully tackling the problem of rising premiums. "Through carrying out regular satisfaction surveys with our business partners and through initiating a new programme of surveying most of our members who undergo treatment, we will continue to monitor these initiatives to ensure they are meeting patients’ needs and achieving our aims."
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