{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:18:56Z","timestamp":1790615936469,"version":"4.1.0"},"reference-count":18,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:00:00Z","timestamp":1790380800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Australas Psychiatry"],"abstract":"<jats:p>Private psychiatric care comprises outpatient as well as private hospital care. The three major funders of private hospital care in Australia are private health insurers, the Australian federal government and, through out-of-pocket costs not covered by the preceding, individual patients. Three big companies, Medibank, BUPA, and nib, dominate the private health insurance market in Australia, resulting in high returns on equity, while private hospitals are being progressively squeezed, resulting in falling profits and a loss in 2024-25. Nonetheless, private health insurers have sought increased collective bargaining power to negotiate fees with private hospitals and care providers, such as psychiatrists, through the formation of buying groups, which would further concentrate the market. In 2021, Honeysuckle Health and nib received authorisation from the Australian Competition and Consumer Commission to act as a buying group for private health insurers with a smaller market share, and other payers. However, a subsequent appeal revealed potential risks to patient and clinician autonomy from buying group contract conditions. In 2026, Honeysuckle Health has applied for an interim and ongoing authorisation from the ACCC to continue as a buying group. We discuss the context and implications of this application for private hospital care, including psychiatry.<\/jats:p>","DOI":"10.1177\/10398562261491618","type":"journal-article","created":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T10:55:25Z","timestamp":1790420125000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Trojan horse? The perils of a private health insurers\u2019 buying group for clinical independence, patient confidentiality, and the viability of private hospital care"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3351-6911","authenticated-orcid":false,"given":"Jeffrey C. L.","family":"Looi","sequence":"first","affiliation":[{"name":"The Australian National University"},{"name":"Consortium of Australian Academic Psychiatrists for Independent Policy Research and Analysis (CAPIPRA)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9264-5310","authenticated-orcid":false,"given":"Stephen","family":"Allison","sequence":"additional","affiliation":[{"name":"Consortium of Australian Academic Psychiatrists for Independent Policy Research and Analysis (CAPIPRA)"},{"name":"Flinders University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6931-2913","authenticated-orcid":false,"given":"Tarun","family":"Bastiampillai","sequence":"additional","affiliation":[{"name":"Consortium of Australian Academic Psychiatrists for Independent Policy Research and Analysis (CAPIPRA)"},{"name":"Flinders University"},{"name":"Monash University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4021-2924","authenticated-orcid":false,"given":"Steve","family":"Kisely","sequence":"additional","affiliation":[{"name":"Consortium of Australian Academic Psychiatrists for Independent Policy Research and Analysis (CAPIPRA)"},{"name":"The University of Queensland"},{"name":"Metro South Addiction and Mental Health Service"},{"name":"Dalhousie University"},{"name":"Australian Society of Psychiatrists"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8216-0694","authenticated-orcid":false,"given":"Luke S. -C.","family":"Woon","sequence":"additional","affiliation":[{"name":"The National University of Malaysia"},{"name":"The Australian National University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2111-9487","authenticated-orcid":false,"given":"Wai-Man","family":"Liu","sequence":"additional","affiliation":[{"name":"The Australian National University"},{"name":"The Australian National University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,26]]},"reference":[{"key":"e_1_3_5_2_2","volume-title":"Hospitals at a glance","author":"AIHW","year":"2026","unstructured":"AIHW. Hospitals at a glance, 2026. https:\/\/www.aihw.gov.au\/hospitals\/overview\/hospitals-at-a-glance (accessed 22 July 2026)."},{"key":"e_1_3_5_3_2","volume-title":"Private Health Insurance Amendment (Modernising the Private Health Insurance Rebate) bill","author":"Parliament_of_Australia","year":"2026","unstructured":"Parliament_of_Australia. Private Health Insurance Amendment (Modernising the Private Health Insurance Rebate) bill, 2026. https:\/\/www.aph.gov.au\/Parliamentary_Business\/Bills_Legislation\/bd\/bd2627\/27bd001 (accessed 30 July 2026)."},{"key":"e_1_3_5_4_2","volume-title":"Honeysuckle Health and NIB","author":"ACCC","year":"2021","unstructured":"ACCC. Honeysuckle Health and NIB, 2021. https:\/\/www.accc.gov.au\/public-registers\/authorisations-and-notifications-registers\/authorisations-register\/honeysuckle-health-and-nib (accessed 15 July 2021)."},{"key":"e_1_3_5_5_2","volume-title":"Deed of Settlement","author":"NAPP","year":"2022","unstructured":"NAPP. Deed of Settlement, 2022. https:\/\/napp.org.au\/wp-content\/uploads\/2022\/08\/20220728-Revised-deed-of-settlement-clean-final.pdf (accessed 15 August 2022)."},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/10398562221140993"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/10398562211030011"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/00048674211038851"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1086\/261404"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1086\/261729"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/0198288816.001.0001"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1162\/003355300555448"},{"key":"e_1_3_5_13_2","volume-title":"Honeysuckle Health Ltd and nib health funds limited","author":"ACCC","year":"2026","unstructured":"ACCC. Honeysuckle Health Ltd and nib health funds limited, 2026. https:\/\/www.accc.gov.au\/public-registers\/authorisations-and-notifications-registers\/authorisations-register\/honeysuckle-health-ltd-and-nib-health-funds-limited (accessed 20 July 2026)."},{"key":"e_1_3_5_14_2","volume-title":"Application for revocation and substitution of authorisation AA1000542 by Honeysuckle Health Ltd and nib health funds limited","author":"Minter_Ellison","year":"2026","unstructured":"Minter_Ellison. Application for revocation and substitution of authorisation AA1000542 by Honeysuckle Health Ltd and nib health funds limited, 2026. https:\/\/www.accc.gov.au\/system\/files\/public-registers\/documents\/Application.Received.-.25.06.26.-.PR.VERSION.-.HH.nib.pdf?ref=0&download=y (accessed 20 July 2026)."},{"key":"e_1_3_5_15_2","volume-title":"Wit v United Behavioral Health","author":"The_Kennedy_Forum","year":"2024","unstructured":"The_Kennedy_Forum. Wit v United Behavioral Health, 2024. https:\/\/www.thekennedyforum.org\/wit\/ (accessed 30 July 2026)."},{"key":"e_1_3_5_16_2","volume-title":"Our position - private health insurance premiums","author":"Catholic_Health_Australia","year":"2024","unstructured":"Catholic_Health_Australia. Our position - private health insurance premiums, 2024. https:\/\/cha.org.au\/wp-content\/uploads\/2024\/08\/CHA-OUR-POSITION-Private-Health-Insurance-Premiums.pdf (accessed 30 July 2026)."},{"key":"e_1_3_5_17_2","volume-title":"Big private health insurers make huge profits\u2026 but they want you to pay more","author":"Richardson D","year":"2025","unstructured":"Richardson D. Big private health insurers make huge profits\u2026 but they want you to pay more, 2025. https:\/\/australiainstitute.org.au\/post\/big-private-health-insurers-make-huge-profits-but-they-want-you-to-pay-more\/ (accessed 6 July 2026)."},{"key":"e_1_3_5_18_2","volume-title":"Australian Health Service Alliance","author":"AHSA","year":"2026","unstructured":"AHSA. Australian Health Service Alliance, 2026. https:\/\/ahsa.au\/ (accessed 20 July 2026)."},{"key":"e_1_3_5_19_2","volume-title":"Safeguards must be maintained in Honeysuckle Health, nib arrangement","author":"AMA","year":"2026","unstructured":"AMA. Safeguards must be maintained in Honeysuckle Health, nib arrangement, 2026. https:\/\/www.ama.com.au\/media\/safeguards-must-be-maintained-honeysuckle-health-nib-arrangement (accessed 30 July 2026)."}],"container-title":["Australasian Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10398562261491618","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10398562261491618","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10398562261491618","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:49:03Z","timestamp":1790614143000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10398562261491618"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,26]]},"references-count":18,"alternative-id":["10.1177\/10398562261491618"],"URL":"https:\/\/doi.org\/10.1177\/10398562261491618","relation":{},"ISSN":["1039-8562","1440-1665"],"issn-type":[{"value":"1039-8562","type":"print"},{"value":"1440-1665","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,26]]},"article-number":"10398562261491618"}}