nib has launched a first-of-a-kind GapSure Anaesthetics network in the Hunter that is designed to provide members with greater certainty when it comes to claiming and out-of-pocket expenses.
Designed in consultation with Pacific Anaesthesia Group, anaesthetists will have the option to 'opt-in' to the program, which will see them agree to charge nib members either a ‘No Gap’ or ‘Known Gap’ fee of up to $500.
nib chief executive of Australian Residents Health Insurance, Ed Close, said since the initial pilot launch in February, over 60 anaesthetists across the Hunter and beyond have registered to the GapSure network.
“Since February, more than 1,800 procedures requiring an anaesthetic were carried out using GapSure, saving our members on average $260 in out-of-pocket expenses where a gap payment was charged,” said Mr Close.
“Importantly, it means our members can have guaranteed certainty around their healthcare costs, which we know has been an ongoing frustration when receiving treatment. Instead, members can focus on their recovery and getting back to full health.”
Mr Close said this is the first time nib has offered a ‘Known Gap’ scheme to healthcare professionals.
“Anaesthetists can choose between a ‘No Gap’ or ‘Known Gap’ fee, which we believe will help reduce common pain-points for specialists when charging members for more complex procedures,” continued Mr Close.
“The decision to include ‘Known Gap’ within the GapSure network was based on feedback from anaesthetists who wanted greater flexibility. Pacific Anaesthesia specialists have worked with nib to ensure this new program helps meet the needs of both patients and the specialists,” he added.
Local adult and paediatric specialist anaesthetist, Dr Simon McLaughlin, of Pacific Anaesthesia Group, said their specialists were already benefiting from the GapSure network.
“When comparing earnings for the participating anaesthetists against our previous case mix earnings, around 80% of anaesthetists earned more under the GapSure network,” said Dr McLaughlin.
“The collaborative approach to the design of the network means nib has helped to address the key challenges experienced by anaesthetists and provided a solution where both the doctor and the patient will benefit.
"We’re proud to have brought about change to nib’s funding model for anaesthetic services that will provide better value for patients, and is a prime example of how stakeholders can work together to support the overall objectives of private healthcare,” he added.
The GapSure network will be rolled out to anaesthetists across Australia from July 2022.