HCF has announced that its agreement with Healthscope expired on 28 September and that they have been as yet unable to finalise commercial terms for a new agreement.
It is understood that the not-for-profit insurer increased its offer over the previous contract.
“HCF is an Australian company and not-for-profit health fund which means its core focus is on the health and wellbeing of its members," said a spokesperson for the company.
“We enter negotiations with our service-providing partners with the mindset of members first, seeking opportunities to partner in value creation activities such as ensuring members' choice as demonstrated through the recent announcement of our Ramsay partnership.
“Unfortunately, Healthscope have put profits and recovery of lost margin due to COVID before patients and willingly acknowledge they will focus on servicing state public health waiting lists and self-insured over private health insurance members.
“They’ve stated they are willing to go out of contract with all private health providers to pursue profits from state government hospitals trying to address long waiting lists."
Healthscope maintains a network of 39 private hospitals across Australia.
HCF said it has around 76,000 claims each year through Healthscope. It said it plans to notify over 6,000 medical professionals that its long-standing agreement with Healthscope is likely to terminate.
“The fundamental of HCF agreements is to keep premiums affordable for our members," continued the spokesperson.
“Healthscope’s mooted policy position to charge gaps and co-payment when accessing services, harvest public patients and self-insured, which will raise the cost of healthcare and no longer recognise the value in private health insurers.
“If HCF were to agree to Healthscope demands the required increase to policy premiums would result in reduced member participation as members higher policy premiums which in return impact members.
“With current cost of living pressures so high HCF cannot agree to Healthscope’s current financial demands and pass them onto members - it’s just not an option. Like HCF, Healthscope needs to put its patients first to reach a reasonable outcome.
“HCF will remain open to consider any alternative Healthscope considers will contain premiums and impact of consumers facing significant out of pockets," added the spokesperson.