Medibank private members in central queensland selected for a pilot program to improve their health

Medibank Private, Australia's largest private health insurer, has launched a "Member Wellbeing Program" pilot, which will link selected members in Central Queensland to services designed to improve their health and wellbeing.

Medibank Private Managing Director George Savvides said the 12-month pilot would measure the benefits of offering members a personalised, tailored approach to improving their health.

"Increasingly, current health thinking advocates the importance of health promotion and early intervention practices. We believe we should offer our members better information and tailored services to help them actively manage their health, rather than just being a claims transaction house," Mr Savvides said.

About 3,500 of Medibank Private's Central Queensland members will soon receive a questionnaire, asking them about their current health, exercise habits, diet and lifestyle. Those who decide to complete the questionnaire will be sent a detailed confidential 'Member Wellbeing Profile', including an explanation of any health risks identified.

The Member Wellbeing Program will give selected Medibank Private members telephone support and health information from health professionals, including dieticians and nurses. The program will also give members a personal health management plan.

Mr Savvides said that the Member Wellbeing Program pilot complemented the work Medibank Private has already done in providing consumer health information via the fund website, and through alliances with the Cochrane Collaboration, the National Asthma Council and the National Heart Foundation.

"Over 90% of members we recently surveyed were in favour of us offering services, such as health improvement programs, that help them manage their health risks or conditions such as diabetes, Mr Savvides said."

The pilot program has been developed in conjunction with Carelink, a division of Australian Health Management Group Ltd, which has extensive experience in running health improvement programs.

"We chose Carelink because they have a track record in health delivery and outcomes, an extensive accredited provider network, and they design their programs and services to engage GPs and other health care providers," Mr Savvides said.

Carelink General Manager, Dale Cairney, is delighted at the new partnership with Medibank Private - "We are keen to work with Medibank Private to achieve its aim of having a positive impact on their members' health", Mr Cairney said.

"Carelink has been at the forefront of innovative health services since 1999 and there is increasing interest across the health insurance industry and private sector in our proactive approach to health. We believe that supporting people to better manage risk and disease is a critical component of sustainability for health insurers."

Mr Savvides said Central Queensland was chosen for the pilot program because Medibank Private membership in that area was representative of its membership nationally.

"It also provides us with the opportunity to provide services to members in regional areas, not just metropolitan areas," he said.

"The Member Wellbeing Program will complement the care currently provided by GPs. We would never interfere with the patient/doctor relationship, but we believe we do have a role to play in helping our members get maximum value out of the health care system.

"We've consulted with the Australian Medical Association, and we've also held meetings with the Central Queensland Rural Division of General Practice and the Capricornia Division of General Practice who support the initiative," Mr Savvides said.

Dr Ross Woodward of Central Queensland Rural Division of General Practice said the Division supported any initiative to improve the general health of Australians.

"This initiative should result in an improvement in health of individuals and a decrease in hospitalisation in the long term," Dr Woodward said.

Dr KP Khor from the Capricornia Division of General Practice said, "with the ever-rising cost of treating chronic diseases in this ageing population, it makes a lot of sense to emphasise preventive health."

"The Program will be evaluated over the 12 month trial period and the results will determine whether Medibank Private will continue this program as a way of positively impacting on the health of our members," Mr Savvides said.

Backgrounder
The Member Wellbeing Program pilot has two components - a Health Risk and Disease Management Program, and a Complex Care Program.

Members selected to participate in the pilot will be asked to complete a Wellbeing Assessment questionnaire that asks about a member's current health, exercise habits, diet and lifestyle. Members volunteering to complete the questionnaire will receive a detailed confidential 'Member Wellbeing Profile', including an explanation of any health risks identified.

Depending on the self-reported risks or conditions identified, these members will then be offered participation in a Health Risk or Disease Management Program suited to their needs.

The Health Risk and Disease Management Program uses Carelink coordinators, such as nurses and dieticians, to make outbound calls linking participants with health information, educational material from recognised bodies such as the National Heart Foundation and Diabetes Australia, and third party health professionals and services.

The Risk Management component of the program will focus on members with issues such as blood pressure, smoking, exercise and weight management. The Disease Management component can assist members with diabetes, arthritis, asthma or chronic heart conditions.

The Complex Care Program will target a small group of Medibank Private members who have a chronic health condition. If they consent to enrol, these members will be offered telephone support and advice by a dedicated CareLink health professional, a care plan developed by CareLink in conjunction with the member's doctor; links to third party health professionals, and services to help them manage their health condition.

More about CareLink
Australian Health Management Group established a Health Management Unit in 1992 with the purpose of providing a range of services and programs to members to assist them in improving or maintaining their health.

The first component of the service offering was a health risk assessment designed to assist members to identify possible health risk and provide personalised health action plans to address these issues. In 1996, the first Member Support Program was launched to provide customised support after a hospitalisation.

With interest from other health funds growing, AHMG established Carelink as a separate business division in 1999.

Carelink employs a multi-disciplinary team of expert health professionals, supported by a clinical management system and all programs are underpinned by clinical protocols and interviewing techniques designed to motivate behaviour change.

Carelink's expertise covers:

• Health risk management
• Support to managing disease
• Assisted discharge from hospital
• Management of people with complex health needs.