Future Solutions for Australian Healthcare
Health Insurance Summit 2014
Dr Avnesh Ratnanesan (Avi)
Founder & CEO, Energesse
Agenda
1. Understanding the Australian Healthcare ‘Eco-System’
2. Major System Challenges and Need for Reform
3. Specific ...
Understanding the Healthcare ‘Ecosystem’
Federal Government
State Government
&
Public Hospitals
Patient/Consumer
Not-
for-...
‘Ecosystem’ is interdependent
Federal Government
State Government
&
Hospitals
Aged Care
Research
&
Academia
Patient/Consum...
Major Challenges with Healthcare System
1. Growth in healthcare costs are ‘unsustainable’ -
$140bil at 9.1% of GDP and out...
OECD Health Expenditure
Australia Health Outcomes
Health Growth Rate vs GDP
Actual Govt Health expenditure
Grattan Institute Report, adapted from The Conversation 24 April 2013
Major Challenges with Healthcare System
1. Rising costs are ‘unsustainable’ - $140bil at 9.1%
of GDP and outcomes goals un...
Chronic disease service load
Major Challenges with Healthcare System
1. Rising costs are ‘unsustainable’ - $140bil at 9.1%
of GDP and outcomes goals un...
Dynamic consumer needs and expectations
Specific Challenges for Health Insurers
1. Rising costs of claims with stagnating
traditional funding models
2. Regulatory...
Future Trends
and
Solution Opportunities for PHI
Develop new innovative funding sources
Population Health Management, Changing
Incentives and Integrated Care
Valuing Service Outcomes:
Cost-Effectiveness & Risk-Share Agreements
Leverage partnerships & bridge silos
Facilitate best practice peer-
sharing & community think-tanks
Enhance trust with stakeholders
Empower Consumers (Community rating)
Empowering Prevention amongst Consumers
AIA Vitality Program
70%
75%
80%
85%
90%
95%
100%
Source: “Participation in an Inc...
Get your strategy right with prevention:
PepsiCo Study
Source: “Do Workplace Wellness programs save employees money . Evid...
Personalised health and Behavioural profiling
to improve adherence
Reproduced with permission from Akumen
Future Solutions for Australian Healthcare
1. Michael Armitage, Private Healthcare Australia
2. George Savvides, CEO, Medi...
For complimentary copy
Call +612 8091 0918
OR
Email
avnesh@energesse.com
Summary
1. Understanding the broader Australian Healthcare ‘Eco-System’
2. Major Challenges within the System and Need for...
For complimentary copy
Call +612 8091 0918
OR
Email
avnesh@energesse.com
Dr Avnesh Ratnanesan - Energesse - Future solutions for Australian Healthcare Reform
Upcoming SlideShare
Loading in …5
×

Dr Avnesh Ratnanesan - Energesse - Future solutions for Australian Healthcare Reform

999 views

Published on

Dr Avnesh Ratnanesan 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

0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
999
On SlideShare
0
From Embeds
0
Number of Embeds
4
Actions
Shares
0
Downloads
39
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Dr Avnesh Ratnanesan - Energesse - Future solutions for Australian Healthcare Reform

  1. 1. Future Solutions for Australian Healthcare Health Insurance Summit 2014 Dr Avnesh Ratnanesan (Avi) Founder & CEO, Energesse
  2. 2. Agenda 1. Understanding the Australian Healthcare ‘Eco-System’ 2. Major System Challenges and Need for Reform 3. Specific Industry Challenges for PHI 4. Future trends and Solution Opportunities for PHI 5. ‘Future Solutions in Australian Healthcare’ White Paper
  3. 3. Understanding the Healthcare ‘Ecosystem’ Federal Government State Government & Public Hospitals Patient/Consumer Not- for- profit Aged Care Research & Academia Private Sector – PC & Hospitals
  4. 4. ‘Ecosystem’ is interdependent Federal Government State Government & Hospitals Aged Care Research & Academia Patient/Consumer Private Sector – PC & Hospitals
  5. 5. Major Challenges with Healthcare System 1. Growth in healthcare costs are ‘unsustainable’ - $140bil at 9.1% of GDP and outcome goals unclear
  6. 6. OECD Health Expenditure
  7. 7. Australia Health Outcomes
  8. 8. Health Growth Rate vs GDP
  9. 9. Actual Govt Health expenditure Grattan Institute Report, adapted from The Conversation 24 April 2013
  10. 10. Major Challenges with Healthcare System 1. Rising costs are ‘unsustainable’ - $140bil at 9.1% of GDP and outcomes goals unclear 2. Ageing population – managing chronic disease and services
  11. 11. Chronic disease service load
  12. 12. Major Challenges with Healthcare System 1. Rising costs are ‘unsustainable’ - $140bil at 9.1% of GDP and outcomes goals unclear 2. Ageing population – managing chronic disease and services 3. Inequitable care – fragmented & uncoordinated delivery 4. Inefficient resource allocation – silo structures and culture 5. System driven by short term activity and measures, rather than outcomes 6. Significant portion of health outcomes is influenced outside the system
  13. 13. Dynamic consumer needs and expectations
  14. 14. Specific Challenges for Health Insurers 1. Rising costs of claims with stagnating traditional funding models 2. Regulatory restrictions prevent efficient management of member health pathways 3. Information asymmetry in clinical practice – variable protocols and moral barriers 4. Consumer disempowerment and complex behavioural drivers 5. Protectionism & lack of trust amongst healthcare stakeholders
  15. 15. Future Trends and Solution Opportunities for PHI
  16. 16. Develop new innovative funding sources
  17. 17. Population Health Management, Changing Incentives and Integrated Care
  18. 18. Valuing Service Outcomes: Cost-Effectiveness & Risk-Share Agreements
  19. 19. Leverage partnerships & bridge silos
  20. 20. Facilitate best practice peer- sharing & community think-tanks
  21. 21. Enhance trust with stakeholders
  22. 22. Empower Consumers (Community rating)
  23. 23. Empowering Prevention amongst Consumers AIA Vitality Program 70% 75% 80% 85% 90% 95% 100% Source: “Participation in an Incentive-based Wellness Program and health care costs: Results of the Not Engaged Benchmark Cancers Cardiovascular Diseases Endocrine and metabolic disease Musculoskeletal Engaged members experienced lower costs per patient Cancers Cardiovascular Diseases Endocrine and metabolic disease Musculoskeletal Engaged members had lower admission rates
  24. 24. Get your strategy right with prevention: PepsiCo Study Source: “Do Workplace Wellness programs save employees money . Evidence from a Fortune 500 company Liu et al. Diagram adapted from www.engagingleader.com/6-lessons-from-pepsi/
  25. 25. Personalised health and Behavioural profiling to improve adherence Reproduced with permission from Akumen
  26. 26. Future Solutions for Australian Healthcare 1. Michael Armitage, Private Healthcare Australia 2. George Savvides, CEO, Medibank 3. Dwayne Crombie, MD, BUPA Health Insurance 4. Mark Fitzgibbon, CEO, NIB 5. Prof Ian Frazer, AC, CEO TRI 6. Prof Stephen Leeder, AO, Chief Editor, MJA 7. Gavin Fox-Smith, CEO Johnson & Johnson 8. Michael Ackland, GE Healthcare 9. John Bronger, Pharmaceutical Society of Australia 10. Dr Martin Cross, Chairman, Medicines Australia 11. Alison Verhoeven, CEO, AHHA 12. Dr Mal Washer, Doctor & former MP 13. Michelle Bridges, Wellness expert and ‘The Biggest Loser’ host .... And 7 other healthcare experts
  27. 27. For complimentary copy Call +612 8091 0918 OR Email avnesh@energesse.com
  28. 28. Summary 1. Understanding the broader Australian Healthcare ‘Eco-System’ 2. Major Challenges within the System and Need for Reform 3. Specific challenges for the Health Insurance Industry 4. Future trends and Opportunities for PHI 5. Future Solutions in Australian Healthcare White Paper
  29. 29. For complimentary copy Call +612 8091 0918 OR Email avnesh@energesse.com

×