MEDICUS FEBRUARY 2016

C O V E R S T O R Y

Medibank’s aim to transform healthcare

Dr Linda Swan Chief Medical Officer, Medibank

O ver the last four decades, Medibank has been a proud contributor to Australia’s world-class healthcare system. Unfortunately, we know that this world- class system, and the finite resources that support it, are under growing pressure. An ageing population, an increase in chronic conditions, new medical technology and a lack of integrated care are all driving up the complexity and cost of healthcare. These pressures directly reduce the affordability of private health insurance, resulting in downgrading or cancelling of insurance cover. This is not just a negative outcome for Medibank, but for hospitals and clinicians as well. As Australia’s leading health insurer, Medibank believes it has a responsibility to work with the medical profession to address these challenges and ensure that the strengths of our health system are maintained. Our aim is to fulfil the triple aim of healthcare

management of chronic conditions in the community and to reduce hospitalisation. This includes a pilot of the CareFirst program in Western Australia in partnership with the State Government. It commenced in 2014 and has already delivered positive results for participants. Medibank is pleased to have helped lead this important national conversation, but we know that much more needs to be done. Importantly, we know that we cannot do this alone and that meaningful change cannot be made without cooperation and consultation with hospitals, doctors and specialists. With a shared understanding of current practice, a definition of best practice, and the right incentives in place, we are confident that we can secure a bright future for Australia’s world-class healthcare system. ■ As Australia’s leading health insurer, Medibank believes it has a responsibility to work with the medical profession to address these challenges and ensure that the strengths of our health system are maintained

been implementing is performance- based measures in our partnerships with private hospitals, including a robust process to help reduce the incidence of hospital-acquired complications and avoidable re-admissions for our members. Medibank has already partnered with over 120 major private hospitals, representing around 70 per cent of all private hospitals in Australia, to implement these important changes. Early indications suggest improvements are already being made in our members’ care as a result. Medibank is also working on ways to share our wealth of clinical data with our clinical partners. This includes working in partnership with professional bodies to share variation in surgical practice, and collecting new patient experience and patient outcomes data. We are already seeing significant benefits as a result. In one case, Medibank data allowed a hospital group to identify unnecessary rehabilitation admissions and reduce those admissions by nearly 20 per cent in 12 months, reducing costs and giving patients a more appropriate setting for their recovery. Outside of the hospital setting, we are improving the way we support our members to live active and healthy lives and encourage more effective healthcare delivery. One example is our innovative CareSuite programs, which support Australians to improve

– to improve health outcomes, healthcare experience, and the affordability of healthcare.

These are values that are shared widely within the healthcare sector, and there has already been a great deal of progress made to protect and progress these aims. We know, however, that we need to do more to secure the future of our health system.

One important initiative Medibank has

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