Introduction of a Private Hospital Services Table of Costs
WorkCover Queensland has introduced a consistent fee schedule for private hospital services in the treatment of patients with a workers' compensation claim. Consultation and feedback from our stakeholders was key to ensuring we continue to meet our customers’ needs.
Background
WorkCover is focused on getting the best outcomes for both employers and workers. This means:
- workers receive timely medical assistance to facilitate their rehabilitation and return to work; and
- treatment must be at a fair and reasonable price to minimise impact on employer premiums.
As the main provider of workers’ compensation insurance in Queensland, we also have a responsibility to maintain the financial viability of the workers’ compensation fund in this state.
Our fee model for private hospital services prior to 1 December 2021 was based on individual contracts with private hospitals across Queensland. The variety and complexity of those contracts made it difficult to achieve consistent pricing and service delivery. It also hindered our flexibility to respond quickly to emergent events (e.g. extending the use of telehealth services during the COVID-19 pandemic).
Insights from research, analysis and consultation with other jurisdictions and key stakeholders, indicated a consistent fee schedule would minimise the disparity in fees and service standards and improve efficiency in billing.
What has changed
The Private Hospital Services Table of Costs, effective 1 December 2021, requires private hospitals providing services to patients with a workers' compensation claim, to invoice for services in line with item numbers and fees listed in the table of costs. The scheduled fees are the maximum payable.
The table of costs will be maintained in a similar manner to our current Medical and Allied Health Tables of Costs with annual and/or interim reviews. This will ensure fees and services are in line with relevant industry and economic factors such as CPI and wage indexes.
Any Private Hospital Facility Agreements with WorkCover Queensland are now invalid for services provided from 1 December 2021.
Stakeholder feedback
The introduction of a consistent fee schedule represented a different way of working for private hospitals within the Queensland workers’ compensation scheme. Key stakeholders and the wider community were given the opportunity to provide feedback on the new process.
Two Open for Comment processes were held: one focused on the structure of the table of costs and the second focused on fees. The two-stepped approach allowed us to consider feedback on the structure prior to setting fees.
Step 1 - Open for Comment – table of costs structure
- Commenced: Wednesday 17 February 2021
- Closed: Wednesday 17 March 2021
Step 2 - Open for Comment - table of costs fees
- Commenced: Wednesday 23 June 2021
- Closed: Wednesday 4 August 2021
The Open for Comment processes were voluntary opportunities for stakeholders to provide submissions for WorkCover Queensland’s consideration. Information collected was used internally by WorkCover to inform future strategy and design decisions in relation to the Private Hospital Services Table of Costs. Stakeholder submissions were not and will not be published publicly. Any personal information collected is handled in accordance with the Information Privacy Act 2009.
Resources
- Frequently Asked Questions (FAQs) are available for more information
- Webinar recording, 17 February 2021 - Open for Comment 1 - table of costs structure
- Webinar recording, 23 June 2021 - Open for Comment 2 - table of costs fees
- Powerpoint slides from 23 June 2021 webinar
Contact us
If you have any questions please email us at communications@workcoverqld.com.au.