The proposal by private hospitals to offer lower rates to patients covered by state-owned insurance companies has hit a roadblock. Several hospitals had said earlier that they were ready to provide discounts to public sector general insurance firms if they managed to give them bulk business.
Third party administrators (TPAs) had said that the move would mean that there would be fewer number of hospitals in the list of cashless facility, which may not be feasible.
“There is a proposal and discussions are on but it would be difficult to carry it out as it would mean reducing the number of hospitals and patients would be left with a limited choice,” a director at a TPA told Hindustan Times.
The four state owned general insurers — New India Assurance, United India Insurance Oriental Insurance and National Insurance Company — control more than half of the health insurance market.
Apollo Hospitals had said that they were ready to offer a 3-7 per cent discount to public sector insurers in case they were able to get bulk business. A senior member of the General Insurance Public Sector Association (GIPSA) said that the proposal is being looked into.
“Though there is a proposal to this effect, no decision has been taken as there are several issues that need to addressed before it can be implemented.” Most insurance firms have quietly started raising premium rates alleging inflating bills by hospitals.
Even for group insurance, pricing is based on claim ratio trends of a particular firm.