When open referral was introduced, a number of my colleagues said: ‘Only Bupa could do this.’
Bupa’s market share and influence can, arguably, enable it to mould medical insurance thinking more effectively than other insurers.
Its bold approach to managing treatment costs, in turn managing client premiums, has been validated to some degree by the recent Competition Commission findings highlighting that hospital costs in some areas should be lower.
Where Bupa led, others followed, seeing the value of open referral to their customers. Implementation and flexibility does play a part in success, however.
When open referral was introduced to our clients, some immediately saw the logic and benefit, while others viewed it less favourably. Certainly we have found no employers have chosen to move to an insurer because they want open referral, but we have seen some move away. The decision as to whether this fits depends on the culture and aims of the organisation.
At Advo, we wholly support the concept and see it as a positive step forward, but it is important to understand that one size does not fit all. Indeed, the very essence of medical insurance is choice and empowerment, something that open referral perhaps removes to some degree.
Insurers that advocate open referral will say choice remains, but with the added benefit of outcome certainty and lower claim costs. But some employers insist it should be up to their employees to select the consultant to look after them. Private medical insurance has always been about choice, the ‘who, where and when’; restricting the ‘who and where’ does not sit comfortably with some employers, regardless of the possible merits.
It is true that insurers with open referral will allow choice; some make it easy, others less so. I commend Bupa for introducing positive innovation, but urge all insurers to continue to allow employees the choice to select what is best for them.
Colin Boxall is commercial director at Advo Group