Physiotherapy Tender Questions and Answers Background 1. Q. Why has Bupa conducted a review of physiotherapy? A. Over the last year, we have been reviewing orthopaedic care to see whether there are opportunities for us to work differently with doctors, therapists and hospitals to improve the quality of care and value for our members. As part of this review we are looking at the provision of out-patient physiotherapy as we believe there is an opportunity to address the variation in the provision and cost of physiotherapy, resulting in better value for our members. 2. Q. What is Bupa trying to achieve? A. Bupa will continue to offer customers access to high quality physiotherapy close to where they live. We believe it is important to manage customer expectations at the start of any treatment, particularly in relation to length, cost and outcome. It is also important to our customers that physiotherapists are able to demonstrate clearly the effectiveness of the treatment offered in terms of both clinical and financial benefits. 3. Q. What do Bupa customers want? A. Our customers want prompt access to high quality physiotherapy close to where they live at prices that offer them good value for money. Bupa believes that the best way to maintain and grow the private medical insurance (PMI) market is to establish new and different ways of working with doctors, therapists and hospitals that will continue to offer Bupa members quality assured care, improved patient service and value for money. Premium inflation is a major issue for Bupa PMI customers and we would like to work with all those involved in private healthcare to reduce premium increases in order to maintain and grow the private healthcare market. The tender 1. Q. How is Bupa conducting the tender process? A. To make it easier for you to provide us with the appropriate information, the tender will be conducted online by completing a questionnaire. The tender documents can be accessed from any computer s internet browser. No software resides on personal computers and the exchange of all relevant information is performed electronically and securely online. By conducting the tender in this way Bupa s aim is to reduce costs and the usual environmental impact of a paper based tender. It also ensures that all Providers are treated fairly and consistently. Parties who are interested in becoming a Bupa Approved Physiotherapy Provider are invited to complete the tender via the website www.bupa.co.uk/physiotender and submit the tender for consideration to Bupa by midnight on the evening of Friday 24 April 2009. 2. Q. What is Bupa hoping to achieve by conducting a tender?
A. The information Bupa receives via the tender will enable us to continue to offer Bupa members access to high quality out-patient physiotherapy treatment close to where they live. It will also allow Bupa to develop a more standardised session length allowing for variation due to clinical needs and establish benchmark session rates. 3. Q. Will I need to complete more than one tender submission? A. You will only need to complete one tender submission if: you have only one facility, you have more than ten facilities for each tender submission, in which case please complete the online tender submission once for your main facility and then contact the support team on 0845 600 4078. We will then send you a template to complete the details for each of your remaining facilities. all facilities have the same pricing (prices shown are for illustration only), e.g. Tender Submission 1 Subspecialty Facility 1 Facility 2 Initial session Follow up session Initial session Follow up session Musculoskeletal 30 20 30 20 Female Health 35 30 35 30 Neurological 40 35 N.B. If a facility does not deliver a certain type of physiotherapy then this does not represent a variation of pricing. You will need to complete a separate submission for all additional facilities where the price you charge for any physiotherapy service (subspecialty) varies between facilities, e.g. Tender Submission 1 Tender Submission 2 Subspecialty Facilities 1-2 (as above) Facility 3 Initial session Follow up session Initial session Follow up session Musculoskeletal 30 20 40 20 Female Health 35 30 35 30 Neurological 40 35 4. Q. For bids that are unsuccessful, will Bupa provide feedback? A. Yes. Bupa is committed to making sure tender process is transparent. 5. Q. Will Bupa guarantee me volumes of patients? A. Bupa cannot guarantee volumes of patients but if you are successful you will be recognised to provide physiotherapy to Bupa members. 6. Q. How do you intend to use the information submitted? A. The information submitted will be used by Bupa to evaluate all submissions received. The information will only be used for the purposes of this tender. The tender document clearly indicates which information may be shared with Bupa members and could be included on a Bupa website. You are provided with an opportunity to agree or disagree to this in the tender. 7. Q. Is the tender for all physiotherapy related treatments? A. The majority of claims received from Bupa members for out-patient physiotherapy are for musculoskeletal conditions; however, Bupa will be including all other specialist areas as part of the tender. 8. Q. How often can I review the agreed tender prices? A. Successful providers will be invited to enter into a two year contract during which prices will remain fixed. You will have an opportunity to agree to a further two years with annual price increases as part of the tender. 2
9. Q. When will the new Bupa Approved Physiotherapy Network be launched? A. The launch of the new network will be on Monday 18 May. Bupa will contact you prior to the launch to confirm the outcome of your submission. Who needs to complete the tender? 1. Q. Do all physiotherapists need to complete the tender? A. All physiotherapy providers, whether individual practices or clinics that treat Bupa members will be required to complete the tender documents. If an individual physiotherapist does not submit invoices directly to Bupa but currently works for a Bupa recognised practice then they do not need to complete the tender. Individual physiotherapists who fall into this category should confirm with the lead clinician/practice manager that they are aware of Bupa s tender and that they intend to submit a proposal on behalf of the practice. 2. Q. What if I choose not to bid? A. Physiotherapists can choose not to bid but at the point at which the new network is launched, they may no longer be eligible to treat Bupa members or invoice Bupa. 3. Q. I work from my own practice and have also agreed to become a partner with a national physiotherapy network provider. I want to submit a tender independently of the national network provider am I able to submit my own tender? A. You will need to confirm with your national network provider whether they will allow this. Bupa will review and assess all submitted tenders and select providers based upon the information provided. Key factors will be sub speciality available, quality, value and travelling distance for our members. 4. Q. I have been approached by a national physiotherapy provider to become part of their network. If I agree to join their network and provide information to them about my practice do I need to complete this tender? A. If you have joined a national network and they have made an application which includes you in their submission, then you do not need to complete this tender independently as your application will be considered as part of the national network s submission. If the national network is successful in becoming a Bupa approved provider you would receive referrals from them and not directly from Bupa Insurance. However, please note that if the national network was unsuccessful, then you too would be unsuccessful and therefore receive no referrals from us. On this basis you may therefore wish to also make an independent submission to us for your practice in order to be considered independently. 5. Q. Is it possible to be successful with both an independent practice tender submission and as part of a network tender submission? A. No. Although we welcome submissions from both independent practices and national network providers, we have decided that a practice can only appear once on our approved network, either as a private practice or as part of a national network. Should we receive dual submissions our final selection decision will consider the overall benefits to both our members and network structure from including you either as an individual practice or as part of a national network. If successful in one capacity, it will not be possible to recognise you in the network in the other capacity. 6. Q. If I decide not to complete the tender for my practice but wish to continue working from a colleague s practice will I remain eligible for re-imbursement? A. If you do not complete the tender or are unsuccessful in the tender process you will not be eligible to invoice Bupa directly. You may however, be included as an individual under the umbrella of another practice and if this practice is successful you will be eligible to work under the terms Bupa agrees with this practice. This practice will need to bill Bupa directly; you will not be eligible to submit invoices directly. Quality and service 3
1. Q. Will the tender not just reduce quality? A. Bupa s primary concern is to ensure that it commissions high quality services on behalf of Bupa customers. In order for a bid to be considered, providers must first meet key quality criteria and will need to agree to supply Bupa with regular quality data about their practice. 2. Q. Why didn t you ask for my clinical input? A. Given that Bupa recognises over 13,000 physiotherapists it was not practical to ask for everyone s clinical input however, we did undertake discussions with a number of providers as well as Physio First and the Chartered Society of Physiotherapy (CSP) to seek their views. 3. Why shouldn t Bupa members be free to be treated whenever they want and won t this mean you are removing patient choice? A. Bupa has a responsibility to its members to ensure quality assured and good value for money care. We want to continue to offer Bupa members access to quality physiotherapy services close to where they live. The physiotherapy tender is not designed to remove patient choice. 4. I have already been quality assessed by Bupa, why do I need to complete the quality section? A. Over the last eight years Bupa has been assessing both the quality and value of the physiotherapy services offered to Bupa members. The tender will confirm that Bupa providers are meeting these standards. 5. I am not happy. I would like to talk to the Chartered Society of Physiotherapy first. A. We are sorry that you are not happy and encourage you to discuss your concerns with us, the CSP and Physio First. We have consulted with both organisations and explained that as a customer driven health and care organisation, Bupa seeks opportunities to address both the provision and cost variation of treatment resulting in better value for our members. Pricing 1. Q. I have already agreed prices with Bupa. Are these no longer valid? A. Successful providers with existing contracts will enter into a new agreement with Bupa which will replace any previous contracts or agreements with Bupa. Unsuccessful providers with existing contracts will continue to treat Bupa members under the existing terms and conditions of their contract (subject to each party s normal termination rights) but any such contract would not be renewed on expiry. 2. Q. Is this just another way to reduce professional fees? A. No. Physiotherapists are increasingly being required to demonstrate the effectiveness of what they do in terms of clinical outcomes and cost. We want to reward providers that provide high quality and cost effective clinical services and are able to provide more clinical information to our members about the physiotherapy they receive. 3. Q. I have a contract to deliver physiotherapy services to a local business group where I treat Bupa members on site. I have offered the group a discounted rate; do I need to complete a separate tender for this service? A. No, as your discounted rate will be lower than the rate you have submitted in your tender, this lower rate will be authorised for payment by our system. You should continue to honour any discounted rates you have agreed with individual businesses. Recognition 1. Q. Can physiotherapists still apply for recognition? A. No. During the tender, all recognition of new providers has been suspended. 4
2. Q. If a physiotherapist has applied for recognition but has not been issued with a provider number, how do they complete the tender? A. Bupa has written to all physiotherapists who have recently applied for recognition explaining why their request for recognition has not been progressed. During the tender, recognition of new providers has been suspended. 3. Q. Will I be able to apply for recognition after the launch of the approved network? A. Physiotherapists working under the umbrella of an approved physiotherapy practice will no longer be required to apply for individual recognition. A physiotherapist who does not have Bupa recognition and wants to open a new practice will need to fulfil the current recognition criteria if they are the lead clinician and complete the online tender and agree pricing. 4. Q. I am currently recognised and will be looking to open a practice next year. Does this mean I will be unable to obtain recognition for my practice? A. Physiotherapists who fulfil the quality criteria and agree pricing with Bupa will be considered on the basis of customer need. For example, if there is inadequate provision within an area to supply Bupa members or the new provider offers a significant clinical advance that, following consultation with existing providers in the area, is considered to be a significant additional service to Bupa members. Bupa members 1. Q. How will this process affect Bupa members? A. There will be no change to the existing arrangements for treating Bupa members until the network is launched. 2. Q. If I refuse to complete the tender or I am not successful, what impact will this have on the member? A. Bupa will notify you of any changes to your recognition status. If you decide not to participate in the tender or are unsuccessful, in the interest of ensuring continuity of care, you will have up to three months to complete the treatment after which the patient should be referred back to the GP or consultant as appropriate. No new preauthorisations for treating Bupa members will be granted during this period which will begin on the network launch date. 5