BUPA Physiotherapy Tender Process

[Mr Manipulator]

The BUPA take in our practice has shrunk from 40% to 20% in the last 5 years, yet overall turnover is maintained, so we voted 'no'. Just shows how worried they must be at the reduction in their market share and also explains their 'desparation' tactics with the tender, in which they might well have shot themselves in the foot. Time will tell.

We still stand to take a pretty decent 'hit' if it doesn't go tits upwards, like I hope it will, but we could not stand by and see our professional autonomy take an even bigger 'hit'!

[londonphysio]

i tendered. For many reasons.
medgen and bupa wellness tendered. 2 of my biggest competitors.
I collect most of the stats they ask for anyway.
The clinical care pathways i found are what we do anyway.
My average session rate and fees are competitive.
Physiotherapy in central london is now more competitive; i believe that for the first time, supply outstrips demand. My experience is that the 'big boys' don't play by the rules of mutual respect and professionalism. Frankly I would rather deal with BUPA than expect solidarity from some physio businesses. I would not be at all surprised if some of those who made the greatest noise tendered in order to clean up.

Before this tender process a successful business model for private practice could be one which charged the most, for the maximum amount of sessions you can give. The patient doesn't care when it is covered by BUPA, so the competitiveness of the marketplace is skewed and the normal market dynamics have not taken place. Now, finally, recognition for practices based at least partly on efficiency will take place. If there are specialisations your stats should be able to demonstrate this; thus valid reasons for significantly higher sessional averages. If there is no specialisation, we will all ahve to change our business models to attract a greater volume of new referrals.

I don't believe my clinical autonomy is at risk. I can back up my assertions with lots of statistics, which include outcome measures (however reliable they are). Most of what BUPA ask are what we do to keep up our standards anyway. When I saw more complex cases, I was able to back up my stats and I was still recognised without having to give a discount.

But...I did not offer a reduction on fees. IMO that would be the beginning of the end. This is where the MRI went sour: they all offered reductions based on the expectation that they would get an increase of volume. But everyone tendered! so no increase of volume.

BUPA are more than 50% of my business. The cost/benefit analysis for me has been simple.

[physiobob]

You should look to the USA for examples of where tendering leads. Fewer competitors, tougher terms every 2 years to continue. Then the inevitable sign or go out of business. Shame really but everyone has to make up their own minds for their own reasons.

I response to your comments on charging the most for the max sessions, that is easily fixed by paying a max per session and a max number of sessions and or a max yearly cover for physio. That's what most do and the market and who sees who generally works itself out. BUPA's actions are likely to be destroying the competitive market until there is one winner.

Best of luck .

[Mr Manipulator]

Dear 'londonphysio',

Your first paragrah disappointments me greatly, particularly as you feel that your competitors would 'ditch' you in such a way. If that is true, you have my sympathy. I am pleased to say that, outside of London (as I am), that appears, so far, not to be the case. Time will tell!

I don't agree that a successful business model is to get what you can out of each and every patient that attends. Each should receive what their condition demands - no less and no more.

Your clinical autonomy is always at risk when you have to justify, to a third party, your actions, based on your professional opinion. The contract for provision of service is between you and the patient, not involving any third parties. How that patient funds their treatment is their affair and should not be yours.

I applaud the fact that you did not drop your fees. From the sound of it, you provide a valuable service which should receive a market based remuneration, and not one that is 'capped' by a third party.

If you could adjust your targetted market to achieve (much) less than a 50% dependance on one diminishing PMI, maybe your cost/benefit analysis could work more in your favour than in theirs.

Whatever, I wish you the very best with your tender, although I am unable to support the action, for reasons well described on this blog.

Best wishes,

Mr Manipulator

[hockeyphys]

i tendered. For many reasons.
medgen and bupa wellness tendered. 2 of my biggest competitors.
I collect most of the stats they ask for anyway.
The clinical care pathways i found are what we do anyway.
My average session rate and fees are competitive.
Physiotherapy in central london is now more competitive; i believe that for the first time, supply outstrips demand. My experience is that the 'big boys' don't play by the rules of mutual respect and professionalism. Frankly I would rather deal with BUPA than expect solidarity from some physio businesses. I would not be at all surprised if some of those who made the greatest noise tendered in order to clean up.

Before this tender process a successful business model for private practice could be one which charged the most, for the maximum amount of sessions you can give. The patient doesn't care when it is covered by BUPA, so the competitiveness of the marketplace is skewed and the normal market dynamics have not taken place. Now, finally, recognition for practices based at least partly on efficiency will take place. If there are specialisations your stats should be able to demonstrate this; thus valid reasons for significantly higher sessional averages. If there is no specialisation, we will all ahve to change our business models to attract a greater volume of new referrals.

I don't believe my clinical autonomy is at risk. I can back up my assertions with lots of statistics, which include outcome measures (however reliable they are). Most of what BUPA ask are what we do to keep up our standards anyway. When I saw more complex cases, I was able to back up my stats and I was still recognised without having to give a discount.

But...I did not offer a reduction on fees. IMO that would be the beginning of the end. This is where the MRI went sour: they all offered reductions based on the expectation that they would get an increase of volume. But everyone tendered! so no increase of volume.

BUPA are more than 50% of my business. The cost/benefit analysis for me has been simple.

Thank you London Phys for voicing the sentiments I've been feeling for some time - hence my decision to tender, but at my full rates and conditions.
I know that when you have a payroll to meet, responsibility to your staff, already do the extras they ask for, and BUPA are a large share of your revenue, you are swayed towards tendering, but would hope when they come back to you to renegotiate you will reply with the same response - i.e this is what we're worth, and this is what we do.

[Deedee]

Loved this letter sent to BUPA by a Scottish Colleague of mine !
.hmmessage P { margin:0px; padding:0px } body.hmmessage { font-size: 10pt; font-family:Verdana }
Dear Jane Gallagher,
Following 26 years as a bupa provider, I thank you for your invitation to submit a fresh tender.
Now semi-retired and complete retirement in the near future a probability, I have decided to remain with my present agreement with bupa.
I assume your youth may render you unaware of the history of your profession, At the conception of the NHS in 1947, physiotherapists gave up professional autonomy to gain entry to the hospital service. It has been a long struggle since the 1970's to slowly regain lost ground which will be eroded if the profession is at the commercial whims of insurance companies.
However, as there will be a shortage of bupa registered practitioners in this area, causing inconvenience to your clients I will continue as a provider, in the interim , till my retirement unless I hear from you to the contrary. In which case I will display this correspondence in my waiting area so your clients can be informed,

[physiobob]

I am wondering if someone might attach their letter or an outline of their letter to any third party/local member/council blah blah so that we might together work on a template that all might use.

Also any useful names and addresses that you can post to the forum to provide the contact points to send them to. This approach worked wonders in the banking world so let's see if we can perhaps make it as easy as possible to get us moving on this.

[Mr Manipulator]

Totally agree, physiobob, but I can't believe how quiet it's gone around here and on the other blog! What are we all waiting for?

[londonphysio]

I am sure it will start hotting up once the results of the tender process are known! Has anyone who tendered heard yet?