Author: Team

Keeping Premiums Low: Towards a sustainable private healthcare system

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[vc_row][vc_column][vc_column_text]“The medical device industry has already delivered $1.1 billion in savings to private health insurers – here’s four ways that another $1 billion can be saved,” Mr Burgess said.

According to APRA figures, MTAA’s Agreement with the Government has already saved insurers $314 million and is on track to exceed the $1.1 billion in expected savings.

APRA data shows that over the last three years, the average benefit paid per device has decreased by 15%, while health insurer profits have increased by 15%.

“MTAA welcomes Health Minister Greg Hunt’s commitment to work with industry to improve the viability of our private healthcare system through existing and new reforms,” said Ian Burgess, MTAA CEO today.

 “This report outlines a range of collaborative sector-wide measures that can be taken to ensure the ongoing sustainability of our private healthcare system.”

Insurers have collected 50% more profit from each of their members over the past five years, far outpacing the 21% growth in benefits paid out. Operational costs have also grown more quickly than benefit payouts, growing at 28%.

Direct constraint of premium growth by high performing health insurance funds, while still allowing continued profit growth, could save $210 million in premium increases for consumers.

Private health funds have not extracted sufficient economies of scale in the wake of significant revenue growth and many funds are well above the industry average of 9% in operational expenditure, this includes an estimated marketing spend of $400 million. Efficiencies in this area could save $210 million.

The need to address operating efficiency was recently acknowledged by Craig Drummond, CEO of Medibank Private.

“For both short and longer-term sustainability of the private healthcare system, optimising models of care will be critical,” said Mr Burgess.

Specific measures such as reducing readmissions, promoting care in the community and reducing overtreatment of patients could deliver $290 million worth of savings towards reducing premiums.

Another $250 million worth of savings could be found through reshaping the allied health offering to exclude therapies for which there is no clinical evidence base.

“In the longer-term, medical technology will be crucial to improving healthcare outcomes and system efficiency,” Mr Burgess said.

“Increased uptake and better funding pathways for emerging technologies such as telehealth, at-home patient monitoring apps and remote diagnosis will help drive better patient outcomes and lower costs.

“’This report proposes a sensible path to reform, with a range of short and longer-term savings and structural solutions.

“On one hand, insurers are patting themselves on the back for skyrocketing share prices, on the other they’re desperately looking to others for solutions, as recently called out by APRA, and even proposing to abolish Medicare.

“We have one of the best healthcare systems in the world, and it is up to all stakeholders to work together to continue to make it better,” Mr Burgess concluded.

The AlphaBeta report can be read here.

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First Female President of the Cardiac Society

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[vc_row][vc_column][vc_column_text]Clara Chow is Professor of the Faculty of Medicine and Health at the University of Sydney and is Academic Director of the Westmead Applied Medical Research Centre and Program Director Community Based Cardiac Services and Cardiologist at Westmead Hospital, Sydney.

The Cardiac Society of Australia and New Zealand is the professional body for cardiologists and those working in the area of cardiology including researchers, scientists, cardiovascular nurses, allied health professionals and other healthcare workers.  The Society is established with the object of promoting the highest standards of education, training, research and practice in cardiovascular medicine and surgery as well as promoting the prevention and control of cardiovascular disease in human beings.

CSANZ President, Professor Len Kritharides, said “the CSANZ is very fortunate to have Clara as its incoming President. She is an outstanding Cardiologist and Researcher and will bring great energy and insight to the role.”

“I am excited and proud to take up the President-elect position of the Cardiac Society of Australia and New Zealand. I think this shows the strong commitment of our society to change and addressing the challenges of diversity for our members as well as our patients,” Professor Chow said.

Prof Chow will serve as President-elect for 12 months and will take up the role of President in August, 2020.[/vc_column_text][/vc_column][/vc_row]

MedTech Innovator Asia Pacific

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MedTech Innovator is the medical technology industry’s global showcase and accelerator for innovative medical device, digital health and diagnostic companies. Its mission is to improve the lives of patients by accelerating the growth of companies that are transforming the healthcare system. MedTech Innovator is the largest platform of its kind, providing participants with broad exposure to the leading players in the medtech industry. To accelerate innovation in Asia, we have partnered with the Asia Pacific Medical Technology Association (APACMed 亚太医疗技术协会). APACMed is the first and only regional association to provide a unified voice for the medical technology industry in Asia.

MEDTRONIC NAMED ON THE 2019 AFR BOSS MOST INNOVATIVE COMPANY LIST

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For the first time in 2019, organisations were ranked directly against their peers across ten industry lists. All lists can be viewed here.

Medtronic ranked #3 on the Health Industry list, from over 800 nominated organisations across Australia and New Zealand. The assessment measures a top innovation implemented in the past twelve months. Specifically, the judges look at how valuable the problem is that the innovation is solving, the quality and uniqueness of the solution, and the level of impact that the innovation has had. Inventium also assesses internal elements such as innovation culture, strategy, resources and process, which demonstrate a sustainable and repeatable approach to innovation.

Medtronic was recognised for its MiniMedTM 670G system launched in early 2019 – an insulin pump system which automatically self-adjusts to deliver people living with type 1 diabetes precise amounts of insulin when they need it. Medtronic also made the list thanks to the exceptional innovation practices adopted by the organisation like fostering a strong internal culture of innovation and engaged employees as part of their leadership expectations and employee development; as well as supporting local medtech incubators and STEM initiatives with local schools and universities.

“Since 1949, meaningful innovation has been etched into everything we do. This spirit of innovation is evidenced in our technologies, and the way we show up to work every day to improve community health outcomes,” said Tim Fortin, Vice President and Managing Director, Medtronic Australasia.

“Globally our therapies help more than two people every second, delivering on our Mission to alleviate pain, restore health, and extend life. At Medtronic, we believe patient-focused innovation – and strong partnerships – remain key to an even better, more impactful future; and that nurturing an innovation mindset supports our team to operate at the highest standards when challenging the status quo to go beyond medical devices to deliver better outcomes to more patients more efficiently.”

 

About The AFR Boss Most Innovative Companies List

The AFR BOSS Most Innovative Companies list (previously the BRW Most Innovative Companies list) is now in its eighth year. The list ranks the most innovative organisations in Australia and New Zealand, and is the only national list of its kind. For the first time in 2019, the list was broken down into 10 industry categories, effectively ranking organisations against their peers. The list is judged and compiled by Inventium – Australia’s leading innovation consultancy. Inventium uses a unique, scientifically proven approach to help organisations grow through innovation. In 2019, the list comprised of ten industry lists of ten, compiled from over 800 nominations, and 400 shortlisted organisations.

GRATTAN INSTITUTE WRONG ON DEVICES

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[vc_row][vc_column][vc_column_text]The medical devices industry has been the sole contributor to reducing the pressure on private health insurance premiums, through the Agreement signed with the Commonwealth in 2017.

This means that, for example, in February 2020, hip replacements will have their 3rd price cut in 4 years.

“Costs for medical devices have fallen in every quarter since the Agreement with the Federal Government signed in 2017,” said Ian Burgess, CEO of the Medical Technology Association of Australia.

“The medical devices industry has been the sole contributor to reducing the pressure on premiums, with another round of price reductions to come in January 2020,” Mr Burgess said.

The Agreement will save private health insurers $1.1 billion in payments for medical devices over the next four years and helped deliver the lowest private health premium increase in 18 years in December 2018.

The benefit paid per device has declined by 1% per annum since 2013, with any increase in expenditure on devices due entirely to an increase in demand.

According to recent APRA data, compared with the March 2018 quarter, March 2019 quarter statistics show that the average benefit paid for all prostheses has gone down 9%.

The Prostheses List is a key part of the value proposition of private health insurance and ensures that surgeons can choose the best available device for privately insured patients without the option being restricted by health funds.

The Prostheses List is a key driver of choice for privately insured patients, enabling surgeons to choose the best possible device for each individual patient.

“The Prostheses List ensures that patient outcomes, rather than insurer profits, are at the centre of patient care. Bundling payments, as proposed by the Grattan Institute, simply serves to incentivise the lowest cost option and restrict access,” said Mr Burgess.

“To make comparisons with international prices is like comparing apples with oranges, as the price of devices can vary due to range of factors, including differences in healthcare systems, purchasing arrangements, geography and other economic factors.

“The medical technology industry believes access to a full range of medical technology is the most valuable component of a private health insurance policy and we’re committed to doing what we do best – assisting patients to lead healthier and more productive lives,” Mr Burgess concluded.[/vc_column_text][vc_single_image image=”3903″ img_size=”full”][/vc_column][/vc_row]

Last chance to nominate – Australian MedTech Industry Awards

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The categories are:

Kerrin Rennie

The Kerrin Rennie Award for Excellence in Medical Technology – Improving Quality of Life was established to recognise and profile the innovative and extraordinary contribution of medical technology in improving health outcomes of Australian patients.

Outstanding Achievement

This award recognises an individual who has contributed in an exceptional way to the medical technology industry in Australia. This may be evidenced through their contribution to industry development, improvement in patient outcomes or excellence in leadership or innovation.

Women in MedTech (WiMT)

The WiMT Awards are presented to an individual and a company who have both been leaders in advancing or achieving a significant result in the WiMT mission or goals within their company or the industry.

Nominate on the MTAA website.[/vc_column_text][/vc_column][/vc_row]

HAIL TO THE (NEW NSANZ) CHIEF

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[vc_row][vc_column][vc_column_text]Melbourne-based Pain Specialist and Anesthetist, Dr Nick Christelis, has hit the ground running in his new role as NSANZ President, spearheading the development of several policies promoting best practice within the neuromodulation industry.[/vc_column_text][vc_separator][vc_column_text]

What is Neuromodulation?

Neuromodulation, also known as Spinal Cord Stimulation, is a minimally invasive and reversible therapy that may prove an effective, additional or alternative option for those who have tried, and failed, conservative pain management treatments. It works by intercepting pain signals as they travel along the nerve fibres through the spinal cord, before they reach the brain.

[/vc_column_text][vc_separator][vc_column_text]One of Dr Christelis’ first actions as president was to announce NSANZ had been awarded charity status by the Australian Charities and Not-for-Profit (ACNC), recognising its invaluable role in striving to uphold the professional practice of neuromodulation across the Tasman, and supporting the estimated one-in-five Australians and New Zealanders living with chronic pain.

Dr Christelis said he was delighted the NSANZ had been award charity status, allowing it to fund and promote further research, educate doctors and establish a neuromodulation device registry.

“I am genuinely excited at the prospect of further consolidating our organisation’s significant success to-date and continuing to strengthen our position as professional pain management industry leaders”, Dr Christelis said.

“We are currently drafting policy documents and guidelines outlining standards for safe and effective neuromodulation practices, encompassing device-related education, training, implantation techniques and management.”

An estimated 3.24 million Australians, including children and adolescents, live with the debilitating affects of chronic pain. Chronic pain is neither preventable, nor the consequence of poor health choice. The condition affects both young and old and can significantly impact a person’s physical and mental health, often leading to social isolation and loss of purpose.

According to a Deloitte Access Economics report released by Pain Australia earlier this year, the 2018 estimated total financial cost of chronic pain in Australia was $73.2 billion, comprising $12.2 billion in health system costs, $48.3 billion in productivity losses, and $12.7 billion in other financial costs.[/vc_column_text][/vc_column][/vc_row]

NIB boss calls for abolition of Medicare

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[vc_row][vc_column][vc_column_text]He described Medicare as a “government monopoly” whilst warning of a growing crisis facing private health insurers over burgeoning costs.

“(The) sensible policy approach would be to make private health insurance compulsory for all Australians with taxation devoted to subsidising the premiums for those who would otherwise be left behind,” Mr Fitzgibbon wrote in an opinion piece for The Australian Financial Review.

“That is, high-income earners would at one end of the scale pay the entire premium while at the other, those with low income fully subsidised.”

This comes as Health Minister Greg Hunt flags the ‘next stage’ of private health insurance reforms, saying he met with private hospitals, private health insurers and other medical leaders: “we’ve got to work on those cost drivers. So, we dealt with prostheses last time, they’ll be coming back to me shortly, those three groups with their suggestions and their proposals”.

The op-ed also came on the back of a report published last week by think tank the Grattan Institute which suggested that the private health insurance industry was in a “death spiral”, a suggestion that Mr Fitzgibbon dismissed, saying “the industry is doing well”.[/vc_column_text][vc_single_image image=”3806″ img_size=”full” alignment=”center” title=”NIB Share Price”][vc_column_text]Mr Fitzgibbon did not believe that his ideas were particularly controversial.

“It’s hardly a radical proposition when you consider Medicare is itself a compulsory ‘social insurance’ system. It’s not as if you or I can opt out of Medicare,” Mr Fitzgibbon wrote.

“And no different to the approach taken by many ‘left-leaning’ European governments that don’t feel it necessary to actually run a health insurance system to ensure cost-effectiveness and fairness.”

The views professed by Mr Fitzgibbon did not garner much public support, with his op-ed slammed across the spectrum of government and industry, with Mr Hunt quick to restate the Federal Government’s unequivocal support for Medicare, saying that the Coalition remained “committed to (Medicare) for life, forever”.

“I did see one comment today questioning Medicare, and I have to say clearly and categorically that we reject that proposition: clearly, categorically and absolutely,” he told reporters this week.

“But equally, we’re committed to private health insurance. Both of those elements are part of the model that best serves Australians.”[/vc_column_text][/vc_column][/vc_row]

Enough Talking – Time for Action on Long-Term Health Policy Vision

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Dr Bartone begun his address by talking of his own personal story and experience with the health system – his mother’s patient journey.

He spoke of being in Brisbane in November 2018 to launch the AMA Indigenous Health Report Card when, that same night, his elderly frail mother fell at home and was admitted to hospital.

“She has not been able to return home since that night. She was eventually admitted to an aged care facility”, Dr Bartone said.

“It gave me, as AMA President and a community GP, an unwelcome front row seat to the care journey of a loved one in our health system. Unfortunately, my mother’s story is not uncommon. It is the same story for many patients in our health system.”

Dr Bartone discussed the significant changes to the health system in 2018, including the 2019 election which he mentioned that “two months on from the election, the need for significant health reforms remains – and it must still be the Government’s highest priority”.

The speech slammed the current health system for its under-funding, under-resourcing, poor access, waste, inequality, and inefficiencies. “From maternity services to primary care, prevention to public hospitals, private health insurance to the Medicare Benefits Schedule, mental health care to indigenous health to aged care” he didn’t hold back on his criticisms.

Dr Bartone said that, for Health Minister Hunt, the time for talk was over. It was now time for action.

Included in his critique of the health system, Dr Bartone called on the Federal Government to ensure the private health sector remains efficient, robust, and productive.

The private health insurance sector has experienced 15 successive quarters of decreasing coverage despite a comprehensive Government review and the transition to the new Gold, Silver, Bronze and Basic policy structure.

However, Dr Bartone said he believes the situation is even worse, citing the “increases in premiums averaging 3 to 5 per cent a year, when wages growth is firmly stuck at around 2 per cent”.

“Sooner or later, the number of people with private health insurance will fall further – and dramatically. This would mean the option of private hospital access would be unaffordable for many Australians,” Dr Bartone said.

“This reform needs to start now – we can’t wait for another dozen quarters of decline. The death spiral is already underway.”

Dr Bartone rounded out his address with a clear call for economic rationalism, highlighting that health care in Australia employs 14 per cent of the nation’s total workforce.

“Driving economic activity through our largest workforce sector would also add extra capacity in general practice, hospitals and other front-line areas.”

Informed Financial Consent Guide launched

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The AMA’s Informed Financial Consent Guide, a collaboration between doctors and patients, is aimed at helping patients better understand medical treatment fees and out of pocket costs.

The Guide will be made available from doctors, medical practices and organisations, and the AMA website.

Providing an estimate of fees and the costs payable by a patient after any government and health insurer rebates is the foundation for informed financial consent. Most doctors do it well already.

The new Guide will complement the Federal Government’s activities to provide improved medical specialists’ costs transparency, to make our system more effective and sustainable.

The Government announced that the improved transparency will help people choose the right specialist, taking cost into account without waiting for an appointment when they may feel locked in regardless of cost.

The Government’s out-of-pocket costs transparency website is being developed in consultation with consumers, medical professionals and insurers to make sure it includes appropriate information and features to assist and support consumers about decisions on their health care.

The website is expected to incorporate MBS benefits and information about insurer gap payment arrangements, in addition to the doctor’s maximum fee and the most common out-of-pocket costs for a treatment.