Private Healthcare Australia

18/12/2025

If you have hip pain, this is a great explanation of the steps you can take to investigate it and explore treatments on offer.

As Charlotte Ganderton and Joshua Heerey write, most hip conditions can be well managed with non-surgical treatments, such as exercises or stretches prescribed by a physiotherapist, doctor or other health-care professional.

You should start by seeking a thorough clinical examination from a trained and registered doctor or healthcare professional such as a physiotherapist who may recommend scans to help diagnose the cause of your pain.

https://theconversation.com/why-does-my-hip-hurt-hip-pain-can-have-many-causes-and-mostly-doesnt-require-surgery-265871

11/12/2025

We commend St Vincent's commitment to deliver half of its health and aged care in people's homes or through virtual platforms by 2030.

PHA has long advocated for increased access to healthcare outside of hospital settings as Australians seek more convenient, personalised care. St Vincent's plan will help more people access care, especially those in rural and regional areas, it will create more flexibility for healthcare workers to do their jobs, and it will free up our hospital resources for the people who need them most.

Our health system is already delivering more care in people’s homes, including post-surgical care, wound management, chemotherapy, and mental health care. But the evidence is clear: we need more of this innovation to create a health system that will meet the needs of our ageing population into the future.

Read more here: https://www.svha.org.au/news/latest/half-of-st-vincent-s-health-and-aged-care-to-be-provided-at-home-or-virtually-by-2030

10/12/2025

Medical billing is complex, and many Australians end up confused about what they’re being charged, especially at a time when cost-of-living pressures are front of mind.

A new book by Dr Margaret Faux, How to Avoid the Medical Bill Rip Off!, offers a practical, plain-English guide to understanding the system. It walks readers through how to choose the right doctor, what to ask before a procedure, and how to avoid hidden or unnecessary fees. The book includes real examples of Australians who reduced their out-of-pocket costs simply by knowing their rights and asking better questions.

The Sydney Morning Herald has shared several helpful excerpts. Read more: https://www.smh.com.au/national/we-have-a-healthcare-system-where-confusion-reigns-and-the-patient-suffers-20251204-p5nksw.html

03/12/2025

Health funds have returned almost $4.8 billion to members in claims savings and givebacks since the Covid-19 pandemic.

During the pandemic, health funds made a promise not to profit from reduced access to health services during lockdowns and restrictions put in place to limit the spread of the virus. They committed to return savings to members through a range of measures, including:

- cashbacks into members’ bank accounts
- deferred and cancelled premium rises, so members paid less for their health insurance
- rollover of extras limits to the following year
- financial hardship packages for people who couldn’t afford to pay their premiums
- expanded cover to include ‘lung and chest’ problems (COVID-19) without charging more for it.

Figures released by the ACCC show health funds have fulfilled this commitment.

More here: https://privatehealthcareaustralia.org.au/health-funds-return-almost-4-8-billion-in-savings-and-givebacks-to-members-new-official-figures-show/

28/11/2025

Health insurers paid out a record $9.4 billion in 'high claims' exceeding $10,000 for hospital treatment in 2024 - a 10% increase on the previous year. These high claims accounted for more than half of all hospital benefits paid by health insurers in 2024, demonstrating the real-world value of hospital cover for thousands of people who used it last year.

Our 2025 Annual Hospital High Claims Report reveals more than 1,000 people were hospitalised with serious conditions that resulted in payments of more than $100,000 each. Their conditions included heart disease, severe infections, cancers, diabetes, and schizophrenia, as well as complications from spinal fusion surgery. Many spent months in hospital. Some spent up to two years in hospital.

The highest paid claim was $697,267 for treatment of severe mitral valve disease with a heart valve replacement that ended with complications.

The report shows how valuable health insurance can be in a health crisis, and how much pressure it takes off our public hospital system.

Read our full report here: https://privatehealthcareaustralia.org.au/half-of-all-health-insurance-claims-for-hospital-care-in-2024-exceeded-10000-new-data-shows/

25/11/2025

Healthy people are paying thousands of dollars for unneeded full-body MRI scans in the hope it will detect early signs of illness. These scans often pick up harmless "incidental findings", causing patients to undergo more tests, including invasive surgical procedures, which can be costly and deliver no real benefit.

Screening for diseases is important when it is supported by scientific evidence and strong clinical guidelines that have balanced the potential harms and benefits, however blanket screening can do you more harm than good. If you want to prevent diseases and maximise your chance of early intervention, speak to your GP about evidence-based tests and screening programs you should engage with.

Read our CEO's comments in today's article in The Age about full-body MRI scans:

A boom in private clinics offering full-body medical scans for patients with no symptoms is leading to unnecessary anxiety, misdiagnoses and invasive investigations, some doctors say.

14/11/2025

Dementia is now the leading cause of death in Australia, according to data released by the Australian Bureau of Statistics. While there's no single solution to preventing dementia and Alzheimer's disease, global research shows that 45% of cases can be prevented.

Here are some top tips on the ways we can all reduce our dementia risk:

1️⃣ Get regular health checks: Visiting your doctor for regular check-ups helps you better understand your health and how you can take care of it. Getting regular checks to keep an eye on your blood pressure, cholesterol, blood glucose, weight, hearing and vision, mental health and cognitive function are important in reducing the risk of dementia.

2️⃣Looking after your body: Heart health, diet, hearing and vision are all factors we should be looking after. Top tips for keeping on top of this including exercising regularly, eating healthy and sleeping well.

3️⃣Keep your mind active: The more active our minds are, the better chances of preventing dementia. Staying socially connected, exercising your brain and taking care of your mental health all contribute.

Check out more tips from Dementia Australia: https://www.dementia.org.au/brain-health/reduce-your-risk-dementia -after-your-mind-and-reduce-dementia-risk

13/11/2025

Have you had a dental check-up this year? Do you need an eye test? If you’re one of the 15 million Australians with health cover including extras, it’s a great time to check you’re accessing benefits that might reset on December 31.

10/11/2025

Navigating the health system can be overwhelming and confusing. This article from The Guardian today includes some tips on how to reduce costs and access more affordable healthcare:

• Your GP can right you a referral to an unnamed specialist so you can phone around a check fees before committing to one
• You can ask your GP for an indefinite referral, rather than one that lasts 12 months.
• A new referral is needed if a new or unrelated condition occurs while on an indefinite referral.
• Once your out-of-pocket medical costs reach a certain threshold, the Medicare safety net gives you a higher amount back for each item for the rest of the year.
• Specialists can charge whatever they want – but patients have the right to ask for an estimate of fees before the service or treatment.
• You can ask your GP to refer you to a public hospital clinic, which is free but where the wait times might be longer.

Read the full article here: https://www.theguardian.com/australia-news/ng-interactive/2025/nov/10/specialist-doctor-medical-referral-fees-rights-medicare-rebates-information

30/10/2025

From 1 November, health funds will be able to pay for Nurse Practitioners who assist with surgical operations, following Albanese Government changes to Medicare.

This is a sensible move that recognises the skill set of Nurse Practitioners and expands workforce options for hospitals across Australia.

PHA continues to call for health funds to be able to pay for Nurse Practitioner consultations in private hospitals to provide Australians with more high-quality options for their healthcare.

30/10/2025

Australian consumers and health insurers are paying an increasing amount towards healthcare in Australia while other sources remain more stable, a new report from the Australian Institute of Health and Welfare (AIHW) shows.

In 2023-24, health insurers contributed $21 billion for healthcare – up 4% on the previous year, and individuals spent $44 billion on healthcare – up 3% on the previous year. Other government sources remained broadly flat.

Health funds are playing a growing role in Australia's mixed public-private healthcare system. We are helping half of all Australians put money aside so they can access rapid healthcare from a provider of choice if they need it.

The reports also shows an estimated $180 billion was spent on disease and injury in 2023-4. Cancer was the most expensive condition ($19.7 billion), followed by cardiovascular diseases ($16.9 billion), and musculoskeletal disorders ($16.3 billion).

Read the full report here: https://www.aihw.gov.au/reports/health-welfare-expenditure/health-expenditureAustralian

29/10/2025

Every Week Counts: The Australian reports new research that’s giving babies a safer beginning

New data shows encouraging mothers to carry their baby to 39 weeks gestation, when safe to do so, can reduce potentially harmful preterm births by up to 10%.

A peer-reviewed study of The Australian Preterm and Early Term Birth Prevention Program, featured in latest edition of The Lancet Obstetrics, Gynaecology and Women’s Health, shows there have been around 4,000 fewer early births each year under the world-first initiative.

Preterm birth (between 37 weeks and before 39 completed weeks) remains one of the leading causes of death and long-term disability in children worldwide.

Induced early deliveries for non-clinical reasons can occur in both private and public health sectors, highlighting the importance of consistent, evidence-based maternity care across all settings.

We’re proud to stand alongside the Australian Commission on Safety and Quality in Health Care in supporting safer, informed care and reducing unnecessary early intervention when there’s no medical need.

You can read the article by Penny Timms here https://www.theaustralian.com.au/health/medical/premature-births-cut-by-up-to-10-per-cent-in-australialed-program/news-story/4780651ee1b84e608f32afd0d4430ca6