Bupa
Bupa is a British international healthcare provisioning and multi-insurance group, with its origins and headquarters in the United Kingdom, but now serving 32 million customers in 190 countries. It is a private healthcare company limited by guarantee, unlike the UK's National Health Service, which is a tax-funded healthcare system. While initially growing organically through green-field expansions, it has recently tended to function akin to a Private Equity firm, with its corporate strategy heavily influenced by M&A activity in order to consolidate itself as a market leader in healthcare provisioning and multi-insurance. It is consistently ranked among the best places to work, having placed 5th in the 2019 edition of LinkedIn's Top Companies in the UK.
History
Bupa was established in 1947 when seventeen British provident associations joined together to provide healthcare for the general public. The firm is a private company limited by guarantee; it has no shareholders, and any profits are reinvested in the business. The service offered by Bupa began as private medical insurance, offering policies to individuals, companies and other organisations, and eventually expanded to include privately run Bupa hospitals.Acquisitions and Divestments
In 2007, the company announced the sale of its UK hospitals to Spire Healthcare. However, during 2008, the firm acquired the London-based Cromwell Hospital flagship hospital to provide healthcare to its members and other private patients including medical tourists from outside the UK.Approval was given in the same year for a merger between Bupa's Australian arm and insurance group MBF. The merger created what is now Australia's largest private health insurance group, with 3.98m lives covered. On 1 December 2008, Clinovia's name was changed to Bupa Home Healthcare. In October 2010 the firm sold Bupa Health Assurance to Resolution Limited, and it has been rebranded as part of Friends Life. At the end of 2012 Bupa acquired the largest private healthcare network in Poland, Lux Med, from the private equity fund Mid Europa Partners for €400m. In February 2015 Bupa acquired a controlling share in Chilean private healthcare network Cruz Blanca, which has a 21% share in the local market. It emerged in January 2016 that the company was to sell its domiciliary care business, which provided care to around 35,500 people, to Celesio AG.
Over the years, it has diversified away from its core health insurance business and is now an international healthcare company with services that include travel insurance, health insurance, care homes, expatriate insurance, health assessments, occupational health services and hospitals. When the Health and Social Care Act 2012 came into force in April 2013 Bupa won the first high-value contract – a £235m deal to provide musculoskeletal services in West Sussex jointly with Central Surrey Health in November 2014.
It bought the dentistry chain Oasis in November 2016 for £835 million from private equity firm Bridgepoint Capital. Oasis runs 380 UK dental practices, both NHS and private, with more than 1,800 dentists. It has an annual revenue of £277 million. The name of the business was changed to Bupa Dental Care. In January 2019 it acquired 9 more practices, making a total of 23 in 6 months.
It bought two care homes in Poole from Primetower in October 2016.
In August 2017 it sold 122 care homes, with 9,000 beds, to HC-One for £300 million.
During the 2018-19 financial year, Bupa remained the biggest player by customer numbers, with almost 3.6 million customers. However, the insurer has experienced losses in Australia- 50,000 net customer losses across all products and almost 80,000 of its core hospital cover customers.
Operations
The company has its head office in central London, with main UK contact centres in Staines and Salford Quays. There are also offices in Brighton, Bristol and Leeds in the UK, Adelaide, Brisbane, Sydney and Melbourne in Australia, Chile, New Delhi, Madrid, Boston, Beijing, Hong Kong, Jeddah, and Miami,.
The firm also owns several healthcare companies overseas including Spain's largest healthcare company, Sanitas, and acquired ihi Danmark and Amedex in September 2005. In December 2007, it purchased DCA Agedcare Group in Australia and New Zealand, making it a leading player in these markets. Also in December 2007, it announced the purchase of Health Dialog, a provider of chronic condition management and "shared decision making" services.
In April 2013, the company acquired Lux Med, Poland's largest private healthcare provider which runs businesses in health funding and provision all over the country through a national network of 194 health centres, including outpatient facilities, diagnostic centres, hospitals, and a large nursing and residential care home.
The firm has entered the Indian health insurance market through a joint venture with the local conglomerate, Max India, called Max Bupa Health Insurance Limited.
In the Middle East, Bupa has entered into a joint-venture partnership with Nazer Group – a family-owned diversified holding company – and created Bupa Middle East in 1997, operating out of Bahrain. When health insurance regulation issues arose in Saudi Arabia, the company was floated on the Saudi stock market as Bupa Arabia, which is currently the leading health insurance company in Saudi Arabia.
According to Stuart Fletcher in 2013 'there was a six percent decline in the number of individuals covered' by private health insurance, 'and the people who are more likely to claim are the least likely to drop the insurance, so the risk pool is deteriorating.' Bupa has protected its finances by reducing payments to consultants. This provoked the British Medical Association to complain to the Competition Commission, which published a report into the private healthcare sector in 2013, probing insurers' power over consultants' fees. It decided that by trying to keep prices down and promote competition, Bupa was doing "exactly what customers would expect". But it did warn that companies like Bupa need to ensure they communicate better with policyholders about what their premiums entitle them to.
Bupa's former Irish subsidiary, Bupa Ireland, was set up in 1996 and eventually had three hundred employees in Fermoy, County Cork and 475,000 members - a 22% share of the Irish market. In 2006 it announced its intention to close in response to the Irish Government's policy of risk equalisation. In 2007 the business was bought by the Quinn Group and traded as Quinn Healthcare. Since 2012 it has been trading as Laya Healthcare, and since 2015 it has been owned by AIG.
Controversies
Bupa has been subject to criticism in Australia and the UK regarding alleged cost-cutting and standards in care homes for elderly people. In each country, it receives public sector funding.Bupa UK has been criticised by some judges, coroners, the Health & Safety Executive,local authorities and care regulators regarding alleged cost-cutting and evidence of institutional failures in some of its UK residential care homes...
Staff and families of residents in some Bupa UK care homes have criticised Bupa for allegedly prioritising profits to the detriment of care.
In 1999 seven care workers who reported abuse of residents to Bupa UK senior management became known as the Bupa Seven in Parliamentary and media reports. One of this group was Eileen Chubb, who claimed in a series of reports that Bupa UK had failed to take remedial action on issues reported by staff and relatives of residents, and that staff had reported to the Care Quality Commission that they were afraid to raise concerns. Some UK care workers have claimed that they were forced to leave or were dismissed for raising concerns to Bupa.
In 2018 Bupa UK was fined £3000,000 after a resident died after contracting Legionnaire's disease.
In 2016, Bupa Australia admitted it had rejected 7,740 claims without a doctor's review in the five years before that date. For years, it had falsely told customers that their rejections had been "determined by a medical practitioner". Bupa detected the failings itself and conducted its own internal investigation before referring the matter to the Department of Health. But the Commonwealth Ombudsman had raised concerns about Bupa's compliance with the law two years earlier, in 2014. There was no public investigation to uncover the full extent of Bupa's failings.
In 2017 it was reported that an Australian elderly cancer patient had been found with maggots 'crawling out of his ears'.
In 2017 Bupa Global reported a data breach involving 547000 health plan customers.
In 2019 Bupa issued a formal apology for care failures in its care homes in Australia after the Minister for Aged Care and Senior Australians Richard Colbeck called Bupa's ""persistent failure" to meet the standards set by the Aged Care Quality and Safety Commission "simply unacceptable".
Also in 2019 the Australian Competition and Consumer Commission alleged misrepresentation of services for which residents had paid, affecting 4,306 of residents in care homes and Bupa issued an unreserved apology and reimbursement with interest.
In 2019, Bupa Australia was accused of not paying up on 270 invoices worth an estimated $73,000 to psychologists treating military personnel. The psychologist said there were bottlenecks with Bupa's referral system causing delays in appointment allocations.