BUPA Physiotherapy Tender Process

[Bupa Physio tender team]

Bupa’s response to online discussions

During the tender process Bupa provided both a call centre and an email address to deal with queries from physiotherapists, as we believed this was the most appropriate way to answer all queries raised during the tender. Over the period of the tender Bupa responded to over 2000 calls and more than 800 emails, therefore I feel that we have given sufficient additional information to assist physiotherapists during this time.

Having howeverread with interest the various comments posted on The Physio’s Voice/The Physio Forum I thought it might be helpful to respond to some of the key points raised on the forum, correct one or two inaccuracies and answer some of the questions raised.

It is understandable that some physiotherapists are concerned about the Bupa tender. Many physiotherapists have contacted Bupa for clarity because they are confused by some of the information they have received from their professional organisations or colleagues – I’d like to reassure all practitioners that we want to work with physiotherapists so that together, we can make sure that patients receive quality assured treatment from a wide choice of physiotherapists.

Clinical autonomy: we do not want to interfere in clinical decision-making or threaten clinical autonomy. We are keen to understand the reasons for both the clinical and financial variation that currently exist and we appreciate that clinicians often treat a wide variety of conditions, some more complex than others, and that there may be valid clinical reasons for such variation. This is why the tender requested providers to develop evidence based treatment plans and share audit data that supports clinical outcomes.

Choice of practitioners: we are not trying to reduce the choice of physiotherapists for Bupa members and there has never been a desire to cap the number of preferred physiotherapy providers with whom we wish to contract. Bupa has not done a ‘U’ turn as described in various physiotherapy publications. We hope that many or all of those providers who submitted a tender will be able to agree contracts with us and join our new network.

Treatment costs: Bupa’s agreement with physiotherapists will be for the reimbursement of treatment costs including an initial and follow-on sessions. The only exception is where the clinician is offering a service that is not refundable under the terms of the patient’s Bupa insurance cover, for example a Pilates class or loan of equipment such as a TENS machine.

We invited clinicians to submit the fees they would charge if they were accepted into the network for the level of service they agreed to provide our members. We want to ensure that the rates our members pay are fair and reasonable. The benchmark prices in the tender are based on recent claims for physiotherapy treatment. In establishing agreements with physiotherapists, a number of factors will be considered: session averages and price are important, as are location, clinical specialties and evidence of service excellence.

Financial savings: By ensuring Bupa members receive quality assured value for money out-patient treatment, our customers are more likely to have the funds available when they need the reassurance of prompt access to care.
Any savings generated by the physiotherapy tender and other similar initiatives will be used to help fund health care for our customers

Clinical practice information: by requesting physiotherapists share information about their clinical practice and rates, we will be able to re-assure Bupa insured patients that a Bupa recognised physiotherapist will provide them with quality assured treatment and value for money; this is information which our customers are increasingly asking clinicians to provide.

Five years’ experience: our customers want the reassurance that the clinicians who treat them are experienced and able to offer specialist skills, hence we do not recognise newly qualified graduates. This applies to all medical practitioners recognised by Bupa Health Insurance, not just physiotherapists. It also applies to practitioners working in Bupa Wellness clinics who are subject to the same criterion. It would not be appropriate to assess the CV’s of all physiotherapists applying for recognition. Bupa realise that there may be clinicians of less than 5 years offering senior skills but to ensure a fair process we have decided not to make exceptions to this criterion.

Legal queries: PhysioFirst and the CSP recognise that it’s entirely appropriate for Bupa to regularly review the services provided to our members. However, they did have some concerns about our approach and have sought legal advice about the tender. Bupa has responded fully to lawyers acting for the professional bodies to all requests for information.

Claims processing: Bupa is not asking providers to process any claims or act on behalf of Bupa. We are asking that all network providers agree to invoice the cost of physiotherapy treatment direct to Bupa and not to request payment from our members. This is because we want our members to concentrate on getting better without the additional worry and hassle of having to pay for treatment and claim it back from Bupa afterwards. In addition to assist the provider with payment we ask that they check the pre-authorisation details with the member to ensure bills are paid.

Next Steps: the online tender is now closed and we are delighted with the response from physiotherapists. We are now reviewing the submissions and finalising the network. The network will be rolled out over the coming weeks.

If anyone has any concerns or questions about the Bupa physiotherapy tender, they can contact our team on 0845 600 4078 or email [email protected].
Mr Steven Pink
Head of Provider Relations and Procurement
Bupa UK Membership

[londonphysio]

So, what does the email above mean? There are lots of people who have received this email. Does it mean yes or no?
We who tendered have been waiting for this with a lot of concern, only to find out today that, well, it might be a yes but you may have to drop your fees first?
Can you tell us what the criterion for inclusion has been when I know my fees and sessional averagesare below those of my local bupa wellness clinic and I have signed up to all of the quality control issues mentioned in the tender?

[rangimarie]

Just received an acceptance letter from BUPA. Thought people might like to know what it says.

"Dear X,

Re.: Bupa UKM Approved Physiotherapy Network Announcement

Thank you for taking part in the Bupa UKM Physiotherapy tender. I am delighted to confirm that your bid was successful and, from 15 May 2009, your clinic/practice will become a Bupa Approved Provider of Physiotherapy services.

We are extremely pleased with the positive response we have received from physiotherapists and have generally found that, like you, most practitioners and practices are committed to the core values which underpin the network; namely, continuing to demonstrate clinical excellence, to deliver greater consistency, to provide customer service excellence, and to offer value for money."

... blah blah blah. It goes on.

Best of luck to everyone else waiting to hear. FYI, I tendered at my normal prices.

[londonphysio]

rangimari are your prices within the benchmark fees?

[rangimarie]

rangimari are your prices within the benchmark fees?

No, they are higher, by more than 25%.

[Chartered Physiotherapist]

Well, Bupa appears to have divided us. Those that successfully tendered, those that failed with their tender and those that didn't tender. Each group will now have their own cause for concern about the future.

Surely now AXAPPP will start to check the new Bupa Network Provider List to ensure parity. How could you justify charging different rates for BUPA and AXAPP patients? This is the tip of the iceberg in my opinion.

[physio4u]

I just wonder if there is any attempt by the insurance companies to set prices won't that amount to price fixing which I thought was illegal. Surely the rules about competition apply equally to the insurers as they do to us??

pt4u

[physiowestlondon]

Just got my contract back from Bupa, signed, and at prices slightly above their 'benchmarked' prices. It's been a bit of a roller coater ride, but I'm happy with the outcome. I didn't even have to drop my standard price - so all good!

[Mr Manipulator]

'Good' on the price side but let's not forget the terms and conditions to which all who tendered had to agree and which, despite what BUPA say, have serious implications for our professional autonomy in the future.

[hockeyphys]

It would be very interesting to know how many of us who tendered at our normal fees recieved letters that they will be reviewing us seperatly
I think it will be most, in which case we are in a very strong position as we are a very large group and BUPA needs us - they cannot go to another group or outsource us to India (as would happen with tenders in other areas of industry) as they are commited to providing a service to thier members.
If we stick to our guns, and maintain our personal fee levels as a group, I believe we are stronger than them.
Can this site set up a poll to see who recieved what letter? (Physio voice seems to have gone very silent on this one unless I'm missing something)
I still don't see where what BUPA are asking for is any different from any other tenders I have completed (NHS, 'middlemen' insurance companies, coporate company contracts) - all of those ask for reports, direct billing,stats and restrict treatment numbers. All will allow you to increase your treatment sessions when you justify it. Every time I have tendered I have done so at a rate that I feel we are worth - some I've lost as a consequence, but have never backed down and won't do so this time.
I actually feel there are 5 groups! - those that tendered below thier fees, (who will now have to work twice as hard to achieve thier previous income) those that tendered at thier normal fees and are awaiting the next stage with interest, those that chose not to tender and are comfortable with it, those who chose not to tender and arn't, and those that negotiated seperatly with BUPA outside the process.
We must remember we are still a strong body with a lot of clout.

[londonphysio]

Hockeyphys physiofirst have started just such a survey. I had an alert Friday evening. Closes tues pm so will have rsults Wednesday I guess

[Frankie]

Just thought I'd let people know. I did tender but at my usual fees (£10 above the benchmark for assessment and follow-up for my area) and have been accepted. Wasn't expecting that!

[londonphysio]

Congrats to those who succeeded. However, it might be that bupa had to agree to higher fees in certain areas in order to get the network? I dont know, but seems likely. I think those who got the 'maybe' email probably had someone else in their area tender below them. Just a thought.

[hockeyphys]

I am now very confused!
After not being at work on Friday, I get in to work today and find 2 BUPA leters plus the e mail I picked up over the weekend!
Letter1 (to me personally) - As you did not tender , you have not been succesful - etc etc
Letter 2 (to me as clinic rep) Pleased to say you have been successful. Attached is a signed contract etc etc
E mail (to me at the clinic) - we will be approaching you for further discussions!
???? - has this happened to anyone else? - shudder to think how BUPA call centres will field patient enquiries and what is on thier database - guess I now have to take more time out composing letters for clarifiaction!
Can anyone post up the link to the physiofirst poll on BUPA's responses so I can access it? (Seem to have let my physiofirst sub lapse in the midst of all this!)

[edgertonman]

Yes we recieved an acceptance letter on Fri followed by personal ones today as we had not tendered individually .An e-mail to BUPA told us that as a clinic we did not need to tender individually if all the physios were happy to have the clinic send inthe accounts.
I would be curious to know how many duplicate entries there are in the total number of physios listed on the Bupa data base.

[archersusie]

Any more news on the BUPA tender, has anyone been de-registered? Are the real winners those who did nothing and the losers those who tendered at benchmark?

[physiobob]

Well as we have heard some people have now begun receiving letters saying they are no longer covered by BUPA.And to add to that their clients have received letters saying they are no longer covered by those individuals. More so that the reason for this is that they ensure they are only covered/treated by senior physios.

Now that's interesting. Perhaps the initial cull is on the more recent graduates already on their books. I've been on their books for 12rys or more since in the UK. I did not tender and so far no letter.

I was thinking about perhaps paying to have some website banner made for anyone who wanted to use one saying something like

"In the interest of an open market this clinic does not recognise BUPA health insurance. We support the physio access for all initiative."

Of course wording that is approved by legal. But something that shifts it back and acknowledges that it should and is We who do not accept them as we did not tender to their conditions and therefore could not be considered.

Any thoughts. I think that if this type of position took hold BUPA would hate the bad press.