Introduction
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During the year Medibank aimed to improve health outcomes, experience and affordability through our quality-focused contracts.
We also focused on protecting customers through our payment integrity program and supporting informed healthcare choices through a range of transparency initiatives.
Central to improving healthcare value is delivering the right care at the right time in the right place – which was the basis for our CareComplete, Medibank Health Concierge and rehabilitation in the home programs.
Hospital contracts
Improving health outcomes, experience and affordability
During the year Medibank continued to introduce quality-focused contracts, which we have now established with all of Australia’s major private hospital groups. These contracts focus on improving our customers’ health outcomes, enhancing patient experiences and improving the affordability of healthcare.
Case study
Medibank and St John of God contract – putting customers first
Medibank and St John of God Health Care signed a landmark agreement in December 2016 – our most patient experience-focused contract to date.
Hundreds of thousands of Medibank customers are treated each year at one of St John of God’s hospitals in New South Wales, Victoria and Western Australia.
The contract between Medibank and Australia’s largest Catholic not-for-profit private hospital group seeks to improve and recognise the quality of care, clinical outcomes and experiences of Medibank’s customers at the group’s 19 hospitals.
Our focus on quality, experience and affordability is reflected in our contractual arrangements with private hospitals and is just one way we are seeking to keep private health insurance affordable and support better health outcomes for our customers.
“We have appreciated Medibank’s initiative in wanting to meet with us quarterly so we can discuss what’s working and what’s not. We’re looking at the bigger picture on how we can collaboratively move the system forward; we’re not just looking at financials all the time.”
Medibank works closely with hospitals to continuously improve patient outcomes and to ensure our customers have the best possible healthcare experience. We commenced asking our customers about their hospital experience in November 2016 using a standardised Patient Reported Experience Measures Survey (PREMS). This survey comprises 31 questions used to measure interactions a patient has with a hospital, including employee responsiveness, cleanliness, quietness and care transition arrangements.
Medibank is gathering data to better understand customers’ preferences and needs, and what they value, when undergoing acute hospital treatment.
Payment integrity
Protecting our customers
Protecting our customers from improper claims and payments means we can take unnecessary pressure off premiums and invest in our customer offering. During the year we continued to focus on identifying and preventing improper claims and recovering improper payments through our payment integrity program.
Transparency
Supporting informed healthcare choices
Medibank and digital health platform Healthshare announced a partnership to give customers and their GPs better access to information about which specialists have offered known or no, out-of-pocket costs for some procedures in the last 12 months. We announced the partnership in February 2017 with the data going live in June 2017.
We partnered with the Royal Australasian College of Surgeons (RACS) to improve surgeons’ access to information on indicators such as complication rates, length of patient stay and costs. This partnership is helping specialists to review their practices to support better clinical outcomes and patient care. During the year we published five of these reports on surgical specialties including general surgery, orthopaedic surgery, and ear, nose and throat surgery.
Patient-centred care
Delivering the right care at the right time in the right place
Around 40% of Australians aged 45 and over live with a chronic disease, which includes conditions such as heart disease, arthritis and diabetes. The prevention and better management of chronic conditions gives people a better quality of life and helps them stay out of hospital. It also takes pressure off the health system and private health insurance premiums.
Our CareComplete program continued to support Australians living with chronic disease. Through the initial pilots and rollout of the program we have enrolled 11,614 patients and worked with more than 1,800 GP clinics and 3,600 GPs (as at 30 June 2017).
Preliminary research shows that the mortality rate of CarePoint participants was nearly a third of the rate of non-participants.
Medibank launched Medibank Health Concierge during the year to support customers preparing for and recovering from a hospital stay. We extended the program to customers undergoing treatment for breast cancer and prostate cancer in June 2017. The program assisted 8,639 customers as at 30 June 2017.
We are partnering with health professionals across Australia to deliver rehabilitation in a customer’s home environment when they are recovering from a hip or knee replacement. Following a successful trial in Victoria, Medibank will make the program more widely available in October 2017. Medibank’s national care coordination and support expertise will help to deliver a high quality care and recovery plan for patients who wish to have rehabilitation in the comfort of their own home, in consultation with the patient’s treating doctor.