A new report released by Bupa shows health insurance claims for knee and hip replacement surgeries were the most expensive items it paid out for in 2018, totalling more than $420 million. The report says much of this is attributable to an ageing and increasingly overweight population. 

This is particularly alarming given that a physiotherapy prescribed exercise and education program, in conjunction with weight management support, could avert more than 70 per cent of knee replacement surgeries alone in Australia each year, saving up to $300 million.

APA National President Phil Calvert is not surprised by the cost explosion in joint replacement claims, saying “Physio research has highlighted the enormous costs of knee and hip replacement surgeries and the subsequent cost saving that could be made by having consumers see a physiotherapist for review before surgery is scheduled.”

“It is international best practice for all patients to be referred to physiotherapy as a first line of care whether they are suffering from mild or severe osteoarthritis, which is the biggest cause of knee and hip replacement surgeries in Australia.”

Bupa Health Insurance Managing Director Dr Dwayne Crombie has also called for better management of patient care and cost expenditure, saying the health insurance system should work together to deliver a sustainable system. “If we want to be able to put downward pressure on health insurance premiums, we need to be able to trial different ways of delivering healthcare which don’t affect quality of care but may reduce cost or give patients more choice.”

However Mr Calvert says the cost burden on consumers who choose the non-surgical approach must be lessened, with Medicare subsidies to encourage a physio-first approach. “Currently, consumers have to pay more out of their own pockets when they take up an early intervention management program for their OA by pro-actively seeking appropriate physio care. Yet if they choose surgery as a first option - which we are clearly seeing all too often judging by these Bupa payout figures - their knee or hip replacement surgery is fully funded via their hospital cover. This just does not make sense.” 


Phil Calvert is available for further comment or interview.


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