Added val­ue of sup­ple­men­tary hos­pi­tal in­sur­ance

Supplementary hospital insurance allows  private  insurers  to  develop  products and services tailored to meet the needs of the insured. A new billing system will offer greater transparency in the future.

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Daniel Liedtke, CEO of the Hirslanden Group, talks about the change in the billing system and the role played by supplementary hospital insurance.

What challenges do service providers face as a result of the change in the supplementary hospital insurance billing system?

Daniel Liedtke: As a hospital group with 17 hospitals in 10 cantons, we have to defend our position in a landscape of more than five dozen supplementary and private insurers. And let’s not forget our more than 2,500 partner doctors, all with different rates that also need to be reflected in the billing system – and that’s over and above the statutory requirements for basic health insurance billing.

What effects do you expect to see from increased transparency in the billing system?

Hirslanden has always been committed to its quality strategy and a clear differentiation of the services provided. So we welcome Finma’s calls for greater transparency from health insurers. The required disclosure of additional customer-oriented services to insured persons makes it easier for us to show all the services we offer in our discussions with the insurance companies. We know that the envisaged disclosure of additional services and the creation of transparency translates into a hefty workload for health insurers, and we are happy to support them.

What is the benefit of the additional services model?

The more transparently we can show the added value that supplementary insurance offers, the more attractive the supplementary insurance becomes. This will benefit insured persons, insurers and the service providers. From age 50 and up, insured persons find it increasingly difficult to change their supplementary health insurance. So it is up to service providers and insurers to develop specific products for these groups of insured persons.

From a service provider’s point of view, what are the most important points when negotiating the new contracts?

Supplementary insurance covers the medical, diagnostic, nursing, therapeutic and service-oriented needs that extend beyond those covered by the Health Insurance Act, and offers the medical innovation that has not yet been incorporated into basic insurance. We refine this customer-oriented added value in all areas on a regular basis and develop additional services based on the current trends and demands of society. We negotiate the prices for these additional services with the health insurers. If the services are in demand, we expect the insurers to pay for them for the insured patients. It is our shared challenge, together with the health insurers, to demonstrate the value of these additional services to insurance customers.

What does a contract-less case mean for a service provider?

For a service provider, this means that patients with supplementary insurance can no longer be treated as such, as in most cases they are not willing to assume the costs themselves. Despite the premiums they have paid to their insurer over the years, these patients are then treated as basic insured patients, which means that they are not free to choose their doctor and cannot use any of the additional services in the hospital concerned. Understandably, this often causes a lot of anger and confusion. In addition, these cases without contracts also send out an extremely bad signal to the market about the value of supplementary insurance.

How important are supplementary insurance services for hospitals?

The income from supplementary insurance services is crucial for hospitals. It is a prerequisite for investment in order to meet the future requirements of our healthcare system and the insured through progress and innovation and to maintain high quality standards.