APRA releases latest private health insurance figures

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 related to membership, coverage, benefits paid, medical gap, prostheses, and medical services.

For the September 2023 quarter, the benefits paid for hospital and hospital-substitute treatments totalled 3,173,479,522 in Australia. Meanwhile, the benefits paid for nursing home type patients totalled 2,724,786, where public hospitals accounted for 2,668,830, and private hospitals accounted for 55,956.

See the rest of the PHI figures for the September 2023 quarter on the APRA website. The next quarterly PHI statistics will be released on Feb. 28, 2024 (December 2023 edition).

APRA responds to PHI reporting standard submissions

Aside from releasing the latest quarterly PHI figures, the APRA published its response to industry feedback on the proposed amendments to PHI reporting standards following the August 2023 consultation.

In a release, the APRA said the following recommendations would apply to reporting periods ending on or after December 31, 2023:

• replacing references to the terms, prosthesis, prostheses, and prosthetic 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 for nursing home type patient in HRS 601.0

The regulator released the amendments in response to six responses from private health insurers, associations, and service providers – all supporting the proposed changes, including the decision to align with updated terminology.

In other news, the APRA has led an independent review of the 2020 General Insurance Code of Practice (2020 Code).