The Australian Prudential Regulation Authority (APRA) has released its latest quarterly private health insurance (PHI) statistics.
The report provides aggregate summaries of key financial and membership statistics, including figures on membership, coverage, benefits paid, medical gap, prosthetics and medical services.
In the September to December quarter, benefits paid for hospital and hospital-substitute care in Australia totalled 3,173,479,522. Meanwhile, benefits paid for nursing home patients totalled 2,724,786, of which 2,668,830 were paid by public hospitals and 55,956 by private hospitals.
APRA responds to submissions on PHI reporting standards
Alongside the release of the latest quarterly PHI figures, APRA released its response to industry feedback on proposed changes to the PHI reporting standards following the August 2023 consultation.
In a release, APRA said the following recommendations would apply to reporting periods ending on or after 31 December 2023:
Replace references to the terms prosthesis, prostheses and prosthetic devices with medical device(s) or human tissue product(s) in line with updates to PHI legislation
Other minor updates to references to relevant legislation, including removing references to the Health Insurance Act in the definition of nursing home patient in HRS 601.0.
The regulator released the amendments in response to six submissions from private health insurers, associations and providers – all of which supported the proposed changes, including the decision to align with updated terminology.
In other news, APRA has undertaken an independent review of the 2020 General Insurance Code of Practice (2020 Code).
