It has become clear that AXA PPP has forged a deal with the management of Ramsay Hospitals without any referral or discussion with consultants who work in these hospitals.
This is a package priced deal for cataract surgery for all PPP subscribers treated in Ramsay Hospitals. Consultant ophthalmologists have been asked to sign up to this deal at a fixed reimbursement rate which includes pre and post operative consultations. A small allowance is made for anaesthetists if they are employed for a case. The hospital is responsible for administering this system and will reimburse the consultant who has no contract with the patient. Reimbursement rates are set well below current BUPA levels.
FIPO has been aware of attempts by insurers to break the patient/consultant contract and indeed PPP have done this with their fixed fee schedule for new consultants. However, this is the first time that an established hospital group has taken this line and participated with an insurer to create a preferred provider system.
All consultants should be aware of the implications of this matter and each will have to decide if they wish to participate in such a system which removes their independence.
FIPO, in conjunction with the Association of Ophthalmologists has written to all ophthalmologists and a copy of this letter can be seen here.