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nib partner with HealthShare to put out-of-pocket information in hands of doctors and consumers

Health insurer, nib, today launched a new partnership with leading health tech company, HealthShare, to enable nib members to quickly and easily determine their likelihood of being charged a gap payment by a medical specialist.

Through the partnership nib members as well as their GP will be able to make an assessment at the point of referral if a medical specialist participates in nib's no gap scheme (MediGap). From later this month, they'll also be able to see the frequency they don't charge nib members a gap or out-of-pocket expense. This information will be available at the point of referral, via GP consultation software, or during online research on healthshare.com.au and the nib website.

Specialists who participate in the nib MediGap scheme agree not to charge members an out-of-pocket cost for their procedure. This helps to minimise 'gap' payments for specialist fees in hospital, in turn lowering member's out-of-pocket expenses.

nib Managing Director, Mark Fitzgibbon, said overwhelming feedback from members is that out-of-pocket costs are one of their biggest pain points.

"It's a market failing that a member can receive treatment for a knee replacement and not be charged a gap, while another member is charged an almost $8,500 out-of-pocket by a different specialist for exactly the same procedure," he said.

Mr Fitzgibbon said the new platform is just one element of nib’s broader long-term vision to put more information in the hands of consumers, empowering them to make better healthcare decisions and generally live healthier lives.

"Just like TripAdvisor has revolutionised the travel industry, we have similar aspirations for the healthcare sector. That's why we continue to seek new ways to correct the current information asymmetry by sharing information such as patient reviews and quality indicators," he added.

Under the partnership, nib members will be able to search for nib MediGap-participating specialists via HealthShare's specialist directory at healthshare.com.au. HealthShare's directory also provides comprehensive information about specialists, including sub-specialties, special interest areas, languages spoken, hospital affiliations, capacity to take on urgent appointments. 

In addition, HealthShare's directory is fully integrated into clinical software that is accessible to over 90% of Australian GPs. This puts valuable health and cost information in front of GPs and their patients, at the time of referral.

HealthShare's CEO, Rami Weiss, has shared the results of a recent HealthShare survey*, which found that 95% of GPs believe specialist fees were an important consideration when referring a patient and over 80% said access to gap participation data would help their referral decision.

"We are thrilled to partner with nib on this important initiative to help their members and GPs who use our digital channels to do their research. We've seen a strong growth in usage of the gap scheme filter with more than 80,000 Australians accessing this data through our website every month," Mr Weiss said.

The online tool is now available to consumers at healthshare.com.au and at nib/com.au/find-a-provider.

*HealthShare Specialist survey, May 2018