Australia's largest health fund has launched a tailored disease and case management service to chronically ill members to help improve the health and quality of life of members.
Medibank Private Group Manager Health Services, Mr Bruce Levy, said, "There are pay-offs for the individual, the health fund, and the community if we can work with members to mitigate and improve the self-management of a range of chronic conditions."
Chronic Obstructive Pulmonary Disorder (COPD) and Chronic Heart Failure (CHF) are the first conditions to be targeted with 1,000 members initially invited to participate in the Member Wellbeing� program.
"We are starting with members we have identified as chronically ill and will hopefully increase our reach to 40,000 members over the next three years making it the biggest direct offering to members in Australian private health care". Mr Levy said.
"Based on National health data we estimate that around 140,000 of our members are likely to have varying degrees of heart failure or a respiratory condition such as bronchitis or emphysema," he said.
Medibank Private data shows that people with these conditions are not only more likely to go to hospital more often, they will generally be in hospital for longer. On average people with respiratory conditions such as COPD have hospital stays twice as long as the average hospital stay and people with heart failure are in hospital for three times as long.
Mr Levy went on to say that the number of annual hospital visits of the 1,000 members invited to participate in the program was on average six times higher than the average of their healthier counterparts. The hospital cost of the same group in the last financial year was 10 times higher than that of similar aged members.
"On the basis of cost alone there is a sound argument for health funds to do what they can to help people with chronic illnesses manage their conditions, prevent deterioration and navigate their way around an often complex health system.
"Our new Member Wellbeing� program provides an opportunity for Medibank Private to assist our members better manage their care, remembering we are not determining treatment, but are reinforcing self-management guidelines and helping members link to necessary local services
"The program is designed to support the care that our members are already receiving from their GPs, specialists and other health professionals involved in the delivery of their care.
"We anticipate that GPs will be closely involved in the program and will receive ongoing updates of their patient's progress on the program," he said.
The program is to be delivered by McKesson Asia-Pacific Limited, on behalf of Medibank Private. McKesson is a leading provider of telephone-based health support programs in Australia and New Zealand and engages health professionals including doctors, nurses, social workers and psychologists to provide a range of health advice for their programs.
McKesson Co-President, Dr Andrew Wilson, commented, "We are delighted to be a core component of Medibank Private's Member Wellbeing program.
"McKesson believe that this initiative will significantly benefit the health and well being of those Medibank Private members involved."
Participants enrolled in the program will each be contacted by a registered nurse who will conduct an individualised assessment of the member's condition and needs. Following the initial assessment patient education and self management advice will be provided. The nurse will also support the member to make healthy lifestyle changes.
Members will be encouraged by the nurse to discuss an action plan developed by McKesson with their doctor to ensure that it is compatible with the treatment they are already receiving from their doctor. The program will also provide member participants immediate access to a 24hr, seven days a week, clinical support and telephone triage service.
Mr Levy said that Medibank Private was building on lessons learnt from recent successful Member Wellbeing� pilot programs and research that suggested there were significant member health benefits and savings from this type of approach.
"If we are going to add value for our members and control premium growth in the longer term we need to do more than simply fund episodes of care in hospital." Mr Levy said.
Medibank Private members should e-mail: medibankhealth@medibank.com.au for more information.
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Medibank Private PH: 03) 8622 5181 / 0411 659 060