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St.LukesHealth and Private Health Insurance 2014-2020 presented by: CN Dockray Chairman St.LukesHealth 26 July 2014. Basic Numbers. Over 11.7 m Australian’s are covered by Private Health Insurance It’s a myth that Private Health Insurance is for the rich.
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St.LukesHealth and Private Health Insurance 2014-2020presented by: CN DockrayChairmanSt.LukesHealth26 July 2014
Basic Numbers • Over 11.7 m Australian’s are covered by Private Health Insurance • It’s a myth that Private Health Insurance is for the rich. • Over 10 m Australians with Hospital cover, • 5.6m have total annual income of $50k or less. • 3.4m or 30% have total annual incomes of $35k or less. • In the case of St.Luke’s, 79% of all policies are written with an FED component.
The role played by PHI in Hospitalisations Public (Medicare) 52% PHI 38% DVA 4% Self Insured 4% Workers Comp 1% Motor Vehicle third party 1%
Our promise to our members We at St.LukesHealth promise every man, woman and child, a relationship they can count on to help them stay healthy, get well and live better.
Our 3 strategic imperatives (pillars) • STAY HEALTHY • Grow healthy members in desired age group • Engage with members to keep them healthy • GET WELL QUICK • Improve outcomes and reduce costs • Engage with members to avoid readmissions and to deliver member satisfaction • LIVE BETTER WITH ILLNESS • Avoid unnecessary events and admissions • Engage with members to avoid admissions and to deliver member satisfaction • LIVE BETTER WITH ILLNESS
Stay Healthy In respect of the “stay healthy” segment we will engage with our members ultimately via: • Educational mailings • Nurse line • On-line health risk assessments • On-line access to personal health records • Reminder systems for screening examinations • On-line self help tools • Integrated wellness programmes • Informing them about the cost benefits of staying healthy We want to help and engage with our healthy members, whatever their age and station in life, to assist them “stay healthy”.
Get Well Quick In respect of the “get well quick” segment (i.e. those following an acute episode of care), we will ultimately engage with them via: • Educational mailings • Assisting pre-planning for hospitalisation • Funding concurrent medical reviews if required • Discharge planning from hospital • Post acute transitional support services • Home health • Behavioural health management, e.g. psychological or CBT treatment following acute care • Nurse line • Informed financial information We want to help our members “get well quickly” with their pre-admission planning and decision making, their discharge planning, their rehabilitation and recovery, so that they return quickly to our “stay healthy” membership segment
Live Better With Illness With respect to the “live better with illness” segment (i.e. the vulnerable to high risk to chronically ill to the end of life members), we will ultimately engage with them via: • Nurse line • Health risk assessments • Chronic disease management (My Health Guardian) • Medication management • Coordinated case management • Behavioural health management • Home health • Informed financial information We want to help this category of our members live as comfortably and independently as possible with as little unnecessary interaction with hospitals and the health care system as is possible.
Our Business Strategy Our business strategy is to: • Encourage wellness and ill health prevention • Be engaged in identifying and assisting our members close gaps in their clinical care • Emphasising and ensuring cooperatively with our members that they receive the appropriate degree of care coordination and accountable care • Educating our members about the high quality and highly efficient providers of care • Educating our members about the costs of their care
Our Core Values Our core values in adopting this new business strategy are: • Respect – we value our members and treat them as we would like to be treated ourselves • Integrity – we hold ourselves to high ethical standards, doing what is right, not just what is easy • Collaboration – we will share information, knowledge and expertise transparently with our members • Initiative – we will consistently follow through on our commitments • Accountability – we will hold ourselves responsible for our actions and be accountable for the results of our actions
Our promise to our members We at St.LukesHealth promise every man, woman and child, a relationship they can count on to help them stay healthy, get well and live better.