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July 2014
Amanda HaganCEO Australian Unity Healthcare
Health Insurance Summit
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Taking time to think
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PHI & primary care
“(Private Health Insurers) have been excluded from the primary care space for historical reasons and if insurers are prepared to work collaboratively with doctors and patients then we should welcome that development.’’
“Sharing information about the patient with all the usual safeguards has the potential to free up capacity for non-insured patients – not detract from it.”
“If an insurer can provide additional support to the doctor around interventions to say a pre-diabetic patient, why would we resist that? It has the potential to save a lot in human and financial terms.”
Federal Health Minister Peter Dutton to the Australian Private Hospitals Association 33rd National Congress, March 24, 2014.
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Flattening the cost curve
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• 2013 calendar year – 971 PHI members managed at home
• Average cost $1,893 per RITH episode
• Average cost of inpatient rehab $6,650
• Average saving $4,757 per episode
• Total cost savings over $4.5 million
Rehabilitation in the Home –
financial outcomes
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• 2013 calendar year – 729 PHI members managed at home
• Average cost $2,162 per HITH episode
• Saving an average of $5,275 per episode (bed day savings calculated at $500 per day)
• Total cost savings almost $4 million
Hospital Care in the Home –financial outcomes
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General Questions
Overall, how did you find the Rehab atHome program? (n=282)
Overall, how would you rate the timelinessand adequacy of your services? (n=272)
How do you feel about your health fundoffering the Rehab at Home program?(n=279)
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Rehabilitation at Home & Early Discharge
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Active participants declined to 36% by the end of the project
• 23% reduced their risk over the trial (as measured by AUSDRISK)
• High risk members that reduced their risk had the highest average steps
• Challenge was participant drop off with only 36% of participants still using their Fitbit after seven months
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Engagement increased materially when participants were targeted & also received coaching
• We conducted a Remedy coaching trial of members with 2 or more risk factors
• Participants were randomly assigned to either receive coaching only or coaching + Fitbit
• Participants with a Fitbit had materially higher engagement than in the staff trial with 77% still using their Fitbit after 6 months (compared to 40% in staff trial)
• Coaching + Fitbit participants had greater reduction in BMI & were more likely to increase physical activity levels
Coaching only Coaching + Fitbit
Take up rate 29% 36%
BMI reduction -0.46 -0.57
% participants increased physical
activity 24% 36%
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Thank you
Questions…