In September, we released our Annual Report for 2014. The Affiliated Provider programme was a focus of the report as part of our long-term strategy to moderate premium increases for members. More than 34 per cent of all Southern Cross claims are through Affiliated Providers and our aim is to grow this to 60 per cent by 2016.
One of the ways to meet this goal will be increasing the services specified as ‘Affiliated Provider-only’ in Southern Cross health insurance policies. This means members on most plans are reimbursed for their services only if they are carried out by an Affiliated Provider. In the 2014 financial year, ten procedures were added to the category of ‘Affiliated Provider-only’ cover.
We are aware that there is resistance by some providers to the Affiliated Provider programme. However, we believe if provider pricing goes unchecked, access to private healthcare options will become increasingly difficult for many New Zealanders.
Southern Cross is a market leader in delivering value to members. As a not-for-profit insurer, for every dollar received in premium income last year, 90.4 cents was returned to members in claims. By comparison, the for-profit health insurers returned an average of only 63.2 cents.