Important Update – Funding Agreement with Australian Health Service Alliance (AHSA)

As a not-for-profit healthcare provider, UnitingCare cannot remain sustainable without adequate funding agreements which allow for the continued provision of quality healthcare for our patients and recognise the impact of rising costs on providing this care.

It is openly recognised that the pressures on our industry are significant, and like all private hospitals, we are facing increased costs in areas including wages, technology, food, energy and maintenance. Now more than ever, we need to ensure our sustainability so we can continue to provide high quality care for our patients.

There will be no immediate impact to existing UnitingCare patients. 

The timing of potential changes are as follows:

• Patients booked and admitted before 21 November will not be affected – current funding arrangements will apply.
• Patients booked and admissions after 21 November may incur additional out-of-pocket costs as the contribution from the patient's health fund may reduce. Some patient cohorts may not be affected  – as soon as this is agreed with AHSA, we will udpate you.

A notice period of 60 business days commenced on 26 August 2024 when UnitingCare provided notice to AHSA to terminate the current contract. During the notice period, there will be no impact to members of AHSA member funds – all procedures will continue without any changes.

If a new agreement is not reached by the conclusion of the notice period, transitional measures will be introduced to minimise disruption for patients.

Following contract termination and the agreed transition period, patients of AHSA member funds will have additional out-of-pocket expenses when attending a UnitingCare hospital.

Patients admitted to any of our four not-for-profit private hospitals — The Wesley Hospital, St Andrew’s War Memorial Hospital, Buderim Private Hospital and St Stephen’s Hospital in Hervey Bay. 

It is vital we receive adequate funding to provide quality health care for our patients. We will continue to negotiate a new agreement with AHSA by 21 November 2024. After which, if an agreement cannot be reached, UnitingCare will end its agreement with AHSA and its member health funds. 

AHSA negotiates hospital funding agreements on behalf of its member funds. AHSA member funds include: 

• ACA Health Benefits Fund  
• AIA Health Insurance  
• Australian Unity Health Limited  
• CBHS Corporate Health Pty Ltd  
• CBHS Health Fund Limited 
• Defence Health   
• Emergency Services Health Pty Ltd
• Frank Health Insurance
• GMHBA
• HBF Health Ltd (previously CUA)
• Health Care Insurance Limited  
• Health Insurance Fund of Australia Limited (HIF)
• Health Partners   
• Latrobe Health Services
• Navy Health    
• Nurses & Midwives Health Pty Ltd
• Onemedifund  
• Peoplecare Health Insurance   
• Phoenix Health Fund  
• Police Health Limited
• Queensland Country Health Fund Ltd
• RACQ Health Insurance
• Reserve Bank Health Society Ltd   
• See-u
• Teachers Health Fund
• The Doctors’ Health Fund Pty Ltd   
• Teachers Union Health (TUH)
• Territory Health Fund
• UniHealth Insurance
• Union Health
• Westfund  

Unless an agreement is reached prior, termination will take effect from 21 November 2024. Following this date, transitional arrangements will be in place to reduce the impacts on specific patient cohorts based on treatment type and patient status. We will share the transitional arrangements when they are made available.

AHSA is yet to advise how much their member funds will contribute towards hospital treatment following the termination and transitional periods. For more information, please contact your health fund directly. 

UnitingCare has agreements with all other major private health insurers in Australia. If you’re currently insured with an AHSA member fund and looking to change funds, there are portability rules which apply. 

A summary of these rules can be found in the Commonwealth Ombudsman’s "The right to change" brochure. Generally, these rules exempt you from having to re-serve the normal waiting periods before you can access hospital benefits if you maintain the same level of hospital cover. However, you may need to serve waiting periods on any additional categories added to your new cover. 

Full details of the Commonwealth Ombudsman Private Health Insurance 'The right to change' can be found here.

We recommend patients speak to their doctor about their personal circumstances.

UnitingCare has agreements with all other major private health insurers in Australia. This means these additional out-of-pocket costs will only apply to patients of funds that are AHSA aligned. 

Under these agreements, the health fund pays an agreed fee in relation to health services provided for patients. This means that patients who are members of these funds will continue to have no out-of-pocket expenses aside from any applicable excesses.

UnitingCare’s current contract with AHSA will terminate from 21 November 2024. There is no immediate impact to current AHSA patients.

We have agreed some transitional arrangements with AHSA member funds to further limit the financial impact of this decision on members of AHSA funds. These transitional arrangements range from three to nine months from 21 November 2024, depending on the treatment type and patient status.  

Once the transitional period expires, patients of AHSA member funds will be required to contribute to their treatment costs to cover the difference between costs of services provided and the amount UnitingCare receives from their health fund.

To find out more about your options, please contact us: 

Website: unitingcareqld.com.au/AHSAupdate

Hotline: 1800 882 217

Email: understandyourcover@uchealth.com.au