nib launches anaesthetics network in the Hunter to reduce member out of pockets

nib Group (nib) has launched a first of a kind GapSure Anaesthetics network (GapSure network) in the Hunter, designed to provide members with greater certainty when it comes to claiming and out-of-pocket expenses.

Designed in consultation with Pacific Anaesthesia Group, anaesthetists will have the option to “opt-in” to the program, which will see them agree to charge nib members either a ‘No Gap’ or ‘Known Gap’ fee of up to $500 for their services.

nib Chief Executive Australian Residents Health Insurance, Ed Close, said since the
initial pilot launch in February, over 60 anaesthetists across the Hunter and beyond have registered to the GapSure network, resulting in important out of pocket savings for nib members.

“Since February, more than 1,800 procedures requiring an anaesthetic were carried out using GapSure, saving our members on average $260 in out of pocket expenses where a gap payment was charged,” Mr Close said.

“Importantly, it means our members can have guaranteed certainty around their healthcare costs, which we know has been an ongoing frustration when receiving treatment. Instead, members can focus on their recovery and getting back to full health,” Mr Close said.

Mr Close said this is the first time nib has offered a ‘Known Gap’ scheme to healthcare professionals.

“Anaesthetists can choose between a ‘No Gap’ or ‘Known Gap’ fee, which we believe will help reduce common pain-points for specialists when charging members for more complex procedures,” Mr Close said.

“The decision to include ‘Known Gap’ within the GapSure network was based on feedback from anaesthetists who wanted greater flexibility. Pacific Anaesthesia specialists have worked with nib to ensure this new program helps meet the needs of both patients and the specialists,” he added.

Local adult and paediatric specialist anaesthetist, Dr Simon McLaughlin, of Pacific Anaesthesia Group, said their specialists were already benefiting from the GapSure network.

“When comparing earnings for the participating anaesthetists against our previous case mix earnings, around 80%[1] of anaesthetists earned more under the GapSure network,” Dr McLaughlin said.

“The collaborative approach to the design of the network means nib has helped to address the key challenges experienced by anaesthetists and provided a solution where both the doctor and the patient will benefit.

We’re proud to have brought about change to nib’s funding model for anaesthetic services that will provide better value for patients, and is a prime example of how stakeholders can work together to support the overall objectives of private healthcare,” he added.

The GapSure network will be rolled out to anaesthetists across Australia from July 2022. For more information, visit: nib.com.au/providers/

[1] Data based on pre and post GapSure claiming for 48 participating anaesthetists