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1
HEALTH INSURANCE SUMMIT
Dr Andrew Wilson
July 2015
2
The Medibank Story
OBJECTIVES
3
Healthcare in Australia is growing at an
unsustainable rate
Total Healthcare expenditure (2011): $130bn (~$6,...
OBJECTIVES
4
CHRONIC DISEASE IS COSTING
5
HEALTHCARE USAGE
Dependency
Mileston
e
Holiday
period
Achieved
Activity
Initiative
BARRIERS TO BETTER HEALTHCARE
Dependency
Mileston
e
Holiday
period
Achieved
Activity
Initiative
NAVIGATING A FRAGMENTED
SYSTEM
Dependency
Mileston
e
Holiday
period
Achieved
Activity
Initiative
THE NEED FOR CHANGE
9
REGULATORY BARRIERS
Existing Private
Health Insurance
regulations offer no
incentive for PHI to
help manage the
health o...
Dependency
Mileston
e
Holiday
period
Achieved
Activity
Initiative
WHAT CAN BE DONE?
Social
services
collaboration
Chronic
...
Dependency
Mileston
e
Holiday
period
Achieved
Activity
Initiative
LEADING POLICY
Social
services
collaboration
Chronic
dis...
Dependency
Mileston
e
Holiday
period
Achieved
Activity
Initiative
GP ACCESS
Social
services
collaboration
Chronic
disease
...
Dependency
Mileston
e
Holiday
period
Achieved
Activity
Initiative
THE APPROACH
Social
services
collaboration
Chronic
disea...
Dependency
Mileston
e
Holiday
period
Achieved
Activity
Initiative
BENEFITS OF PRIMARY CARE
Social
services
collaboration
C...
Dependency
Mileston
e
Holiday
period
Achieved
Activity
Initiative
INTEGRATED CARE
Social
services
collaboration
Chronic
di...
Dependency
Mileston
e
Holiday
period
Achieved
Activity
Initiative
GARRISON HEALTH
Social
services
collaboration
Chronic
di...
Dependency
Mileston
e
Holiday
period
Achieved
Activity
Initiative
HEALTHCARE FOR THE FUTURE
Social
services
collaboration
...
18
KEEPING HEALTHCARE AFFORDABLE
What Medibank is doing:
1. Paying hospitals a fair rate to look after our members
2. Focu...
Dependency
Mileston
e
Holiday
period
Achieved
Activity
Initiative
FOR BETTER HEALTH
Social
services
collaboration
Chronic
...
20
Thank You
Dr Andrew Wilson
Executive General
Manager, Provider
Networks and
Integrated Care
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Dr. Andrew Wilson - Medibank - We can afford the future of our health system…but we can’t afford the waste

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Dr. Andrew Wilson delivered the presentation at the 2014 Health Insurance Summit.

The 2014 Health Insurance Summit focused on how legislative changes affect the future of health insurance in funding, membership and services.

For more information about the event, please visit: http://bit.ly/HISummit14

Published in: Business
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Transcript of "Dr. Andrew Wilson - Medibank - We can afford the future of our health system…but we can’t afford the waste"

  1. 1. 1 HEALTH INSURANCE SUMMIT Dr Andrew Wilson July 2015
  2. 2. 2 The Medibank Story
  3. 3. OBJECTIVES 3 Healthcare in Australia is growing at an unsustainable rate Total Healthcare expenditure (2011): $130bn (~$6,000 per capita) Hospital costs represented 38% of expenditure (excl. CapEx) State and Federal Government was responsible for 70% of expenditure Healthcare now accounts for ~30% or more of State budgets Between 2006 and 2011 GDP in Australia grew at ~3.0% CAGR Between 2006 and 2011 healthcare costs grew at 8.5% CAGR
  4. 4. OBJECTIVES 4 CHRONIC DISEASE IS COSTING
  5. 5. 5 HEALTHCARE USAGE
  6. 6. Dependency Mileston e Holiday period Achieved Activity Initiative BARRIERS TO BETTER HEALTHCARE
  7. 7. Dependency Mileston e Holiday period Achieved Activity Initiative NAVIGATING A FRAGMENTED SYSTEM
  8. 8. Dependency Mileston e Holiday period Achieved Activity Initiative THE NEED FOR CHANGE
  9. 9. 9 REGULATORY BARRIERS Existing Private Health Insurance regulations offer no incentive for PHI to help manage the health of their members.
  10. 10. Dependency Mileston e Holiday period Achieved Activity Initiative WHAT CAN BE DONE? Social services collaboration Chronic disease management Patient wellbeing Improved patient outcomes & reduced hospital admissions
  11. 11. Dependency Mileston e Holiday period Achieved Activity Initiative LEADING POLICY Social services collaboration Chronic disease management Patient wellbeing Improved patient outcomes & reduced hospital admissions
  12. 12. Dependency Mileston e Holiday period Achieved Activity Initiative GP ACCESS Social services collaboration Chronic disease management Patient wellbeing Improved patient outcomes & reduced hospital admissions
  13. 13. Dependency Mileston e Holiday period Achieved Activity Initiative THE APPROACH Social services collaboration Chronic disease management Patient wellbeing Improved patient outcomes & reduced hospital admissions involve assessment and care planning coordinate care across all parts of the health system address gaps in care and non- compliance
  14. 14. Dependency Mileston e Holiday period Achieved Activity Initiative BENEFITS OF PRIMARY CARE Social services collaboration Chronic disease management Patient wellbeing Improved patient outcomes & reduced hospital admissions coordinate care across all parts of the health system address gaps in care and non- compliance Patient and care team Individual care plan Patient has responsibility for their own health 5.5 4.5 4.2 3.6 2.2 Major Cities Inner Regional Outer Regional Remote Not stated Very remote Expenditure Per Person By Service & Region (2008) Source: Australia’s Health 2010 1,311 753 312 1,428 661 346 1,468 576 318 1,723 409 243 Admitted Patient Medicare PBS Pharmaceuticals Major City Inner Regional Outer Regional Remote and Very Remote Ave. $ per Hospital Separation by Remoteness (2008) Source: AIHW National Public Hospitals Establishment Database, 2005 3,651.6 3,887.5 3,965.1 4,328.6 4,422.3 Major Cities Inner Regional Outer Regional Remote Very Remote
  15. 15. Dependency Mileston e Holiday period Achieved Activity Initiative INTEGRATED CARE Social services collaboration Chronic disease management Patient wellbeing Improved patient outcomes & reduced hospital admissions coordinate care across all parts of the health system address gaps in care and non- compliance GP Management Plan / Team Care Arrangements Practice Nurse coaching sessions (face to face) Allied Health sessions Telephonic and Online coaching sessions Integrated content, tools, goals, and evaluation
  16. 16. Dependency Mileston e Holiday period Achieved Activity Initiative GARRISON HEALTH Social services collaboration Chronic disease management Patient wellbeing Improved patient outcomes & reduced hospital admissions coordinate care across all parts of the health system address gaps in care and non- compliance
  17. 17. Dependency Mileston e Holiday period Achieved Activity Initiative HEALTHCARE FOR THE FUTURE Social services collaboration Chronic disease management Patient wellbeing Improved patient outcomes & reduced hospital admissions coordinate care across all parts of the health system address gaps in care and non- compliance Patient and care team Focus on diet, exercise and healthy behaviours Individual care plan Patient has responsibility for their own health
  18. 18. 18 KEEPING HEALTHCARE AFFORDABLE What Medibank is doing: 1. Paying hospitals a fair rate to look after our members 2. Focussing on quality and outcomes 3. Ensuring our members get the right treatment when they need it 4. Helping eliminate improper payments 5. Working with governments to continually improve the operation of the healthcare system
  19. 19. Dependency Mileston e Holiday period Achieved Activity Initiative FOR BETTER HEALTH Social services collaboration Chronic disease management Patient wellbeing Improved patient outcomes & reduced hospital admissions coordinate care across all parts of the health system Patient and care team Individual care plan Patient has responsibility for their own health We all have a role to play in working towards ways to reduce the burden of chronic disease, and through cross- sectorial collaboration, we can overcome regulatory barriers to achieve better coordinated and integrated care, to ensure that we really are working towards the better health of all Australians.
  20. 20. 20 Thank You Dr Andrew Wilson Executive General Manager, Provider Networks and Integrated Care
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