Hospitals divided over uniform rates

COIMBATORE: Hoping to make healthcare affordable, four insurance firms launched the Preferred Provider Network (PPN) wherein policy holders can avail the benefits of a uniform price for health care which will be paid directly by the insurance agency to the hospital.
Inaugurated in the country 2 years ago, the policy was launched in the city recently, roping in 46 hospitals in the region that will offer more than 100 medical procedures under this scheme. United India, New India, Oriental Insurance and National Insurance, all public sector insurance agencies, are part of this project.
Hospitals are however divided on the merits of this policy. Hospitals that are unhappy with the introduction of this insurance scheme argue that as the quality of service varies from hospital to hospital, the rates cannot be uniform. In addition, a bulk of the hospitals was not consulted.
Insurance agencies on the other hand say that this has been introduced to benefit all the stakeholders in the medical sector, especially patients. "The huge disparity among hospitals with regard to the treatment costs is a concern raised by all," said M A Azeez, chief regional manager of the United India Insurance. As per the PPN, a fixed rate has been agreed upon by the hospitals. Three are different slabs with regard to the type of facilities they avail and the procedures they undergo. The charges will be reimbursed directly to the hospitals and the policy holder will be spared the agony of mobilising the funds immediately, he said.
Some hospitals said they are happy to be part of the project. K Ravishankar, general manager of the Neuro Foundation, Salem, said that this will help avoid complaints of patient exploitation.
However, the Indian Medical Association (IMA) has come out against this plan. They say that a general plan is not feasible for all hospitals. Besides, it was introduced without taking into confidence all parties. Dr A K Ravikumar, President IMA Coimbatore said that all hospitals cannot follow a similar rate. "We agree that there should be standardisation of rates. But the rates fixed by the insurance firms are not acceptable. They have lured some hospitals with promises of more patients. Ideally, rates should be based on the facilities and procedures of the hospital and the expertise of the physician involved," he said.
Dr V G Mohan Prasad, Chairman of the VGM Hospital said that there will be differences in cost regarding aspects like accreditation. "A hospital accredited with the National Accreditation Board for Hospitals (NABH) will have at least 10 percent more expenses than a normal one for its procedures and other aspects," he said.