From 2012 to the end of 2014, Helsana was able to reduce prices for supplementary hospital insurance. However, current demographic trends and the associated hospitalisation rate are posing a risk to these price reductions. Semi-private and private wards will become more expensive.
Since the introduction of the flat-fee-per-case system in 2012, anyone needing inpatient treatment can choose to be treated at any hospital in Switzerland. With this new system, certain services were transferred from supplementary insurance to the basic insurance. The aim of this legislation was to create a level playing field for public and private providers, which reduced the burden on supplementary hospital insurances.
Thanks to this change, Helsana saved a total of CHF 78 million on all its supplementary hospital insurances. Helsana became the first insurer to grant its customers a 5% discount for 2012 and 2013. In 2014, premiums were reduced nationwide.
Several reasons for the rise in costs
It has, however, become apparent now that this positive effect has already been offset again. The reason for this is that competition between hospitals is not developing as hoped. Helsana expects that, in the medium term, it will not be possible to keep the costs of supplementary hospital insurance at the level of recent years. Why is this? Before the introduction of hospital financing in 2012, costs were not fully covered by the basic insurance. This led to hospitals receiving some compensation through supplementary hospital insurance. The prices did not match the added value the hospitals offered.
Another reason for the rise in hospital costs are recent demographic trends. In short: more and more people require more and more hospital care for age-related matters. At the same time, hospitals have seen a rise in the number of patients suffering from more than one disease who often have to stay in hospital for an extended period. This is not only difficult for sufferers and their families, but also represents a substantial financial burden on the healthcare system as a whole.
To tackle these challenges effectively, Helsana is committed to offering affordable premiums. This requires a differentiated assessment of the tariffs of all clinics and hospitals involved in order to stabilise premiums for hospital products. The aim is to promote and expand cooperation with hospitals which have a reasonable and affordable tariff structure.
Text: Andrea Hohendahl