Medibank today announced that it had redefined its involvement in primary care to focus on helping tackle chronic disease following the evaluation of a couple of its primary care pilots.
Executive General Manager, Provider Networks and Integrated Care, Dr Andrew Wilson said that everyone who worked at Medibank was motivated by improving the health of all Australians and believed that primary care was integral to managing chronic disease.
“Having evaluated a number of the primary care pilots we are running with partners at the moment, we’ve seen that closer collaboration with primary care and GPs, particularly in the areas of preventative health and tackling chronic disease and complex conditions, is better for our members’ health and also makes business sense.
“Our CareFirst pilot with IPN medical centres in Queensland has been designed specifically to do that and is receiving positive feedback from both participating GPs and patients, we’ve also seen improved health outcomes from the first round of participants including healthy levels of weight loss, regular exercise habits, and consistent healthy eating behaviours as well as enhanced medication management.
“Following the evaluation of our GP Access pilot, which has also been running out of 26 general practices in Queensland for the last 18 months, we are now of the view that there are better ways we can support primary care. We will be ceasing to offer the GP Access pilot to our members after 31 July this year.
Medibank’s review of the GP Access pilot, which had aimed to enhance the value of health insurance for Medibank members, and to support GPs and promote the importance of primary care, found that while the 13,000 members who used the service were pleased with it, they didn’t feel it added additional value to their private health insurance.
Dr Wilson also said that Medibank had engaged with stakeholders during the pilot and had listened to their concerns and that this had assisted with Medibank’s decision making about primary care involvement.
“Disappointingly, it was clear from the feedback that this pilot was perceived as a first step towards the creation of a two-tier or exclusive health system. Medibank is a strong supporter of universal health care, and we would certainly hate people to think that we were trying to do anything like this.
“Primary care is really important and needs greater resourcing and support, and we want to assist in that.
“Stakeholders also told us that GPs feel stretched and unable to provide the longitudinal care they’d like to be able to provide their patients battling chronic illnesses and complex health issues.
“Through both our CareFirst and Care Point pilots we are now working closely with GPs so they can do more for their patients, particularly in tackling chronic disease and keeping people out of hospital.
“Our research shows that people battling chronic illnesses and complex health issues often feel confused and distressed by the range of options and find it difficult to navigate their way through the health system.
“We are providing GPs with additional resources to provide this type of care and creating programs to help people battling chronic illnesses and complex health issues “join the dots” and provide them with a holistic understanding of their health and the system.
“Not only do we believe these new pilots will lead to better health outcomes for participants, but also to reduced costs through more co-ordinated care and reduced hospital admissions. Case studies from overseas have proven this,” said Dr Wilson.
Dr Malcolm Parmenter, CEO of IPN said that IPN was pleased to be working with Medibank on the CareFirst pilot: “CareFirst is being piloted out of six of our clinics and our GPs are great supporters of this pilot. We hope to expand this to more of our clinics in the coming months.”
Medibank will be actively expanding the network of GP clinics with a view to increasing the availability of the CareFirst program to as many people as possible.
Medibank is also running an integrated care pilot called CarePoint in Victoria in partnership with the Victorian Government, the Health Innovation Reform Council (HIRC) and in Western Australia in partnership with the WA Government and HBF.
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About Medibank’s CareFirst pilot
CareFirst Chronic is a chronic disease management program which started in September 2014 and runs out of six GP clinics in South-East Queensland, in Aspley, Everton Plaza, Kedron Park, Mermaid Waters, Browns Plains and Deception Bay.
CareFirst provides participants with enhanced chronic disease management and aims to improve the health and avoid unnecessary hospital admissions of Medibank members who have the following chronic conditions:
- Chronic Heart Failure;
- Chronic Obstructive Pulmonary Disease;
- Osteoarthritis;
- Diabetes (Type 2); and
- Coronary Artery Disease.
Participating GPs are supported to enrol Medibank members they identify with chronic health conditions into the program, which then runs for 16 weeks. Patients in the program are provided with a care plan and health coaching, and are supported by telephonic and online education and navigation. The GPs receive funding for patient enrolments and participation in the program, as well as for health improvements.
CareFirst has over 200 patients currently enrolled, with the first patients to complete being well on their way to achieving their health goals.
A snap shot of patient feedback about how they are achieving their goals:
“I have lost weight and my waist measurement is down, I am very happy”
“I am following the diet the dietician has given me”
“I have been using the nurse’s techniques and have cut back on how much alcohol I drink every day”
“I have been following the exercises in the pool that the physio has given me”
“I have started taking the stairs everyday instead of using the lift”
“I have started going for walks everyday”
“This (CareFirst) is the best thing I have ever done ... I’m telling you things I have never told other people”
The CareFirst Program is being evaluated in conjunction with the School of Public Health and Community Medicine at the University of NSW.
About Medibank’s CarePoint pilot
CarePoint is an integrated healthcare pilot that supports both public and private patients battling chronic and complex health issues. It provides general practitioners (GPs), physicians and other clinicians with additional support to help them and their patients navigate the healthcare and social services available. The pilot is running in Victoria and in Western Australia.
The service provides additional resources to participating GPs to help them better support both public and private (either Medibank or HBF) patients battling chronic illnesses and complex health issues. These include a dedicated clinician for each clinic, phone-based administration and logistics support (including booking appointments and liaising on a regular basis with patients, families and carers), hospital liaison officers at major hospitals, home nursing and community care workers to visit enrolled patients and health coaching programs.
Launched in August 2014, the Victorian CarePoint pilot will run for two years, out of medical centres in the Mornington Peninsula, Frankston, Casey, Bayside and Inner Eastern Melbourne areas, and aims to enrol both Medibank members and public patients through participating GPs. The Victorian pilot is a partnership between the Victorian Government, the Health Innovation Reform Council (HIRC) and Medibank.
Launched in September 2014, the Western Australian CarePoint pilot will run for two years, out of medical centres in North Metropolitan Perth, and aims to enrol 500 Medibank members, 500 HBF members and 350 public patients through participating GPs. The Western Australia pilot is a partnership between the Western Australian Government, HBF and Medibank.
About Medibank’s GP Access pilot
Medibank’s GP Access pilot was first launched in October 2013 in six clinics and was expanded in April 2014 to 26 general practices in Queensland in Brisbane, the Gold Coast, Ipswich and Cairns. The pilot will cease on 31 July 2015.
The GP Access pilot, which aimed to enhance the value of health insurance for Medibank members, and support GPs and promote the importance of primary care, has been providing Medibank members in participating locations with:
- Same-day appointments - when members call one of the participating GP clinics before 10am weekdays they are guaranteed an appointment for that day. If members call later, the clinic will do its best to fit them in.
- Fee-free consultations - members who show their Medibank card at a participating clinic or who use the after-hours GP will pay no out-of-pocket costs for the consultation.
- After-hours GP home-visits - members in Brisbane metro areas can access an after-hours home GP visit within three hours.
A range of one-off health assessments available to people at different life stages with no out of pocket costs.
Medibank will advise members who used the service in the last 6 months that the will cease on 31 July 2015