New Models of Care                                         November 2012                                          Fergus C...
Agenda   • Supply   • Demand   • New model of care requiredPrimary Care Conference, November 2012   2
Demand                                         Population Projections >65yrs   1,600,000   1,400,000   1,200,000   1,000,0...
Demand                                         Claims Cost per Insured Person 2011                                        ...
Demand                                          GP consultations by age group                                             ...
Demand                       Medical Cards (000s)                                                1,759                    ...
Supply (Public)                                                      Total Health Public Expenditure (incl CAPEX)  18000  ...
Supply (Public)                                                                             Public In-patient Beds        ...
Supply                                                                        GPs as a share of total doctors, 2009   100%...
New Model of Care                Hospital Setting                      Quality                     Primary Care Setting   ...
New Model of Care                                                  Larger                                                 ...
Summary                                               The whole is other than the                                         ...
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Fergus Clancy, CEO, Mater Private

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New Models of Care

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Fergus Clancy, CEO, Mater Private

  1. 1. New Models of Care November 2012 Fergus ClancyPrimary Care Conference, November 2012 1
  2. 2. Agenda • Supply • Demand • New model of care requiredPrimary Care Conference, November 2012 2
  3. 3. Demand Population Projections >65yrs 1,600,000 1,400,000 1,200,000 1,000,000 800,000 600,000 400,000 200,000 0 2010 2020 2030 2040 2050 65-80yrs >80yrsSource: CSO, EurostatPrimary Care Conference, November 2012 3
  4. 4. Demand Claims Cost per Insured Person 2011 €3,333 €2,442 €1,469 €793 €469 €409 €224 €164 0- 17 18-29 30-39 40-49 50-59 60-69 70-79 80+Primary Care Conference, November 2012 4
  5. 5. Demand GP consultations by age group 5.4 4 3.7 3 2.7 2.6 2.4 18-24 25-34 35-44 45-54 55-64 65-69 70+Source: CSO (Q3 2010)Primary Care Conference, November 2012 5
  6. 6. Demand Medical Cards (000s) 1,759 1,649 19% increase in number of medical cards issued since 2009 – at its highest for 40 years 1,479 Jan 2010 Mar 2011 Mar 2012Source: DOHCPrimary Care Conference, November 2012 6
  7. 7. Supply (Public) Total Health Public Expenditure (incl CAPEX) 18000 16000 14000 12000 10000 8000 6000 4000 2000 0 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 e 2014 e 2015 e 2016 e 2017 eSource of 2002-2011 data: Health in Ireland, Key Trends 2011, DOHC. 2013 - 2017 based on 5% cut in first 3 years.Primary Care Conference, November 2012 7
  8. 8. Supply (Public) Public In-patient Beds 12,110 12,123 11,847 11,538 11,159 10,807 2006 2007 2008 2009 2010 2011Source: In-patient & Day Case Activity Data: Hospital In-Patient Enquiry (HIPE), ESRIPrimary Care Conference, November 2012 8
  9. 9. Supply GPs as a share of total doctors, 2009 100% 90% 80% 70% 60% 50% 40% 30% 49.8 49.0 47.4 46.0 41.9 38.9 20% 36.7 33.1 33.2 32.0 32.0 29.8 29.3 25.9 25.1 24.9 22.7 20.7 20.3 20.1 19.7 19.6 18.0 16.7 10% 15.9 15.8 13.8 13.5 12.3 11.7 9.5 4.5 0% GPs OtherSource: OECD Health at a glance 2011Primary Care Conference, November 2012 9
  10. 10. New Model of Care Hospital Setting Quality Primary Care Setting Critical mass and multi-disciplinary care Selected Procedures in Sufficient High unit price and Volumes low access caps activity €100 x 1,000 The Unit = €100,000 Sweet Price Spot Clinical Leadership & Less Bureaucracy Low unit price and high access drives activity Agreed Treatment €50 x 3,000 = €150,000 Guidelines VolumePrimary Care Conference, November 2012 10
  11. 11. New Model of Care Larger Primary Care Centres Selected Proper procedures financial in sufficient incentives volumes The Sweet Spot Clinical leadership ICT & MDT an less linkages bureaucracy Agreed treatment guidelinesPrimary Care Conference, November 2012 11
  12. 12. Summary The whole is other than the sum of its parts The Sweet Spot • Stronger clinical leadership • Better patient experience • More efficient use of scarce resources Gestalt Theorist: Kurt KoffkaPrimary Care Conference, November 2012 12

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