During 2011, Vhi Healthcare paid out E39.3 million in claims for the healthcare needs of its customers in Tipperary. The biggest spend involved claims for the treatment of cancer which exceeded E6.24m, including E1.2m spent on claims for breast, bladder and prostate malignancy. Orthopaedic procedures including replacement knee and hip joints, fractures and back problems accounted for a further E5.5m of total spend, while heart and circulatory conditions cost almost E5.4m to treat. Claims benefit of €2.3m was allocated to cover 725 claims for arthritis and rheumatism.
Customers from Tipperary admitted to hospital for treatment of digestive system problems such as stomach ulcers, gallstones, inflammatory bowel disease etc., incurred costs of almost E4m. Additionally, nearly E3.7m was allocated for claims associated with the central nervous system (brain and spinal cord) and included expenses relating to the treatment of strokes, brain haemorrhage, damage to nerves and many other conditions. Some E3.5m was allocated to investigation of non-specific symptoms and illnesses and claims for which no final diagnosis could be established. Mental health issues for people living in Tipperary - including treatment for depression, anxiety, personality disorders and psychoses came to over E1.7m. Respiratory problems that included pneumonia, asthma, viral infections etc cost almost E2.1m to treat.
According to John O Dwyer, Chief Executive, Vhi Healthcare, “We are very focused on cost containment and believe it is central to delivering affordable healthcare. Our approach has been multifaceted and we have looked at all areas of the business to achieve savings. Since 2009, Vhi Healthcare has reduced consultants’ fees by 15% and has also reduced the prices we pay for various procedures by between 13% and 53%. For example in the case of a heart patient, the professional fee paid for the insertion of an ordinary stent has gone from E1,100 to E220, for someone requiring an MRI Scan the cost has gone from E650 to E160, or for someone who requires treatment to save their sight because they suffer from age - related macular degeneration the cost of that injection has gone from E306 to E200.”
Furthermore, he continued: “In our agreement with consultants for 2012 we have introduced a payment system for Radiologist and Pathologists based on the National Quality Benchmarks which will in effect reduce length of stay particularly for medical admissions. This has the potential to save E42 million per year for Vhi Healthcare in hospital costs. The cumulative effect of our cost saving initiatives means that when the current agreement with consultants ends in 2014 we will have turned back the clock 10 years because the benefits we pay to consultants will be in line with what we paid in 2004.”
Other claims payouts for Vhi Healthcare customers in Tipperary included:
• E1.16m paid out on maternity deliveries, including complications;
• E2.1m for treatment of eye conditions;
• E979,000 for treatment of skin conditions;
• More than 660 customers in Tipperary suffered slipped discs at a cost of E505,000;
• E236,000 for treatment of alcohol and other substance addictions;
• E430,000 for treatment of customers with pneumonia;
• E305,000 for 260 customers admitted with acute respiratory infections;
• E273,000 for 177 people with varicose veins;
• E326,000 for 214 customers with men’s health issues.
• E230,000 for 172 customers needing surgery to correct congenital issues present since birth;
Even fit people can incur claims costs as more than €1.1m was paid out on 560 claims for customers from Tipperary injured in falls, domestic accidents, workplace injuries, on the farm, or while engaged in sports and leisure activities.