Medicare Select
Cindy Shay
Executive Policy Relationships
How Medicare Select works
Universal
scheme
Individuals
contributions not
linked to health
status
Fund holder
procures
serv...
Our Vision
Purchasing
IP
Medicare Select is our ideal model for a reformed health system
that enables us to deliver on our...
The healthcare challenge
Expenses on health and
aged care are expected to
exceed revenue by 2050.
Three major trends driving this change
1. Our growing,
ageing population
is living longer
2. Increasing need
and costs for...
Medibank forecast of Australian health expenditure
Medibank forecast of health expenditure to 2025
Medibank forecast of Australian health expenditure
Medibank forecast of health expenditure to 2025
Medibank forecast of Australian health expenditure
Medibank forecast of health expenditure to 2025
Medibank forecast of Australian health expenditure
Medibank forecast of health expenditure to 2025
Medibank forecast of Australian health expenditure
Medibank forecast of health expenditure to 2025
2. Chronic disease is driving health costs
Source: MPL data
Consume 45% of all
hospital and medical
expenditure
70% of thi...
• In 2007-08, 35% of the
population had at least
one chronic disease,
which equates to more
than 7m Australians.
• An esti...
The healthcare challenge
Ageing population
3. Health technology is now more than
10% of health costs, and growing…
Top 5 procedures 2010*
Prosthesis Usage Total cost...
The healthcare challenge
Ageing population
…while our ability to pay is reducing
Source: IGR2010
Our Vision
Purchasing
IP
Medicare Select is our ideal model for a reformed health system
that enables us to deliver on our...
Other countries are using these models already
The journey to date
Has the time for reform passed?
There are already similar models in place
(eg Medibank ADF)
Other current reforms
XXX
XXXX
XXXX
Next steps
!"
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Thank you.
Any questions?
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Cindy Shay

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Cindy Shay

  1. 1. Medicare Select Cindy Shay Executive Policy Relationships
  2. 2. How Medicare Select works Universal scheme Individuals contributions not linked to health status Fund holder procures services - USO
  3. 3. Our Vision Purchasing IP Medicare Select is our ideal model for a reformed health system that enables us to deliver on our purpose, For Better Health Co-Ordinated Care Gateway 24x7 Purchasing IP
  4. 4. The healthcare challenge Expenses on health and aged care are expected to exceed revenue by 2050.
  5. 5. Three major trends driving this change 1. Our growing, ageing population is living longer 2. Increasing need and costs for chronic disease treatment 3. New technology driving costs up
  6. 6. Medibank forecast of Australian health expenditure Medibank forecast of health expenditure to 2025
  7. 7. Medibank forecast of Australian health expenditure Medibank forecast of health expenditure to 2025
  8. 8. Medibank forecast of Australian health expenditure Medibank forecast of health expenditure to 2025
  9. 9. Medibank forecast of Australian health expenditure Medibank forecast of health expenditure to 2025
  10. 10. Medibank forecast of Australian health expenditure Medibank forecast of health expenditure to 2025
  11. 11. 2. Chronic disease is driving health costs Source: MPL data Consume 45% of all hospital and medical expenditure 70% of this group have underlying chronic disease
  12. 12. • In 2007-08, 35% of the population had at least one chronic disease, which equates to more than 7m Australians. • An estimated 2% of the population have four or more concurrent conditions. • As the likelihood of having a chronic condition increases with age, so does the number of concurrent conditions. 2. Chronic disease increases with age
  13. 13. The healthcare challenge Ageing population
  14. 14. 3. Health technology is now more than 10% of health costs, and growing… Top 5 procedures 2010* Prosthesis Usage Total cost Average Cost per Tx Hip replacement 4,486 $46,802,438 $10,433 Knee replacement 5,814 $46,738,746 $8,039 Cardiac defibrillator 533 $27,660,035 $51,895 Spinal Fusion 1,548 $23,997,096 $15,502 Cardiac Pacemaker 1,830 $22,997,610 $12,567 Source: Medibank Private Health Benefits Report 2010 Total 14,211 $168,195,925 $98,436
  15. 15. The healthcare challenge Ageing population
  16. 16. …while our ability to pay is reducing Source: IGR2010
  17. 17. Our Vision Purchasing IP Medicare Select is our ideal model for a reformed health system that enables us to deliver on our purpose, For Better Health Co-Ordinated Care Gateway 24x7 Purchasing IP
  18. 18. Other countries are using these models already
  19. 19. The journey to date
  20. 20. Has the time for reform passed?
  21. 21. There are already similar models in place (eg Medibank ADF)
  22. 22. Other current reforms XXX XXXX XXXX
  23. 23. Next steps !" #$% & ' () * +& , % + - + + $ . & & */ 0 " 1 " 2/ 0 "+3% "$/ , & * / +3 4 &$0
  24. 24. Thank you. Any questions?
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