Category: News

New data reveals insured patients can still face significant out- of-pocket dental costs

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[vc_row][vc_column][vc_column_text]AIHW spokesperson Dr Adrian Webster said that good oral health is fundamental to general health and wellbeing. Without it, a person’s general quality of life and the ability to eat, speak and socialise is compromised, resulting in pain, discomfort and embarrassment.

‘However, for many Australians, cost may be a barrier to ensuring they receive the care they need, when they need it,’ he said.

The report, Oral health and dental care in Australia, draws together data from a variety of sources to explore the oral health of Australians and their use of dental care services.

Recent data published by the Australian Bureau of Statistics shows that in 2017–18, half (50%) of Australians aged 15 and over said they had seen a dentist over the past 12 months. However, a national study of adult oral health conducted by the University of Adelaide found that in the same year, about 2 in 5 (39%) said they avoided or delayed visiting a dentist due to the cost, and this was more common among people who were not covered by private health insurance.

‘More than half (52%) of people without insurance said they avoided the dentist because of the cost, compared with about 1 in 4 (26%) people with insurance,’ Dr Webster said.

Even those people who receive dental treatment using their private health insurance can face substantial out-of-pocket costs. For example, the median out-of-pocket cost after using their health insurance for a full crown was $786. However, there was a great deal of variation between patients, with some paying as little as $26 out of their own pockets, and others paying $1,989.

Other, more routine procedures also saw great variation in out-of-pocket costs even after private health insurance payments.

‘The median out-of-pocket cost for people using private health insurance for a preventive service to remove plaque or stains was $16, but some patients paid up to $82, while others paid nothing,’ Dr Webster said.

Today’s report also suggests that some Australians are more likely to see cost as a barrier than other groups. For example, Aboriginal and Torres Strait Islander people were more likely to report avoiding the dentist due to cost than non-Indigenous Australians (49% compared with 39%), and females were more likely than males (43% compared with 35%).

‘Visiting a dentist regularly has many benefits. These visits provide an opportunity for preventive dental care, which can stop problems developing, and can facilitate treatment to repair or reverse damage to teeth and gums,’ Dr Webster said.[/vc_column_text][/vc_column][/vc_row]

NEW AMA PRESIDENT CALLS TO REVIVE ECONOMY

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[vc_row][vc_column][vc_column_text]The election, at the AMA’s National Conference, follows the conclusion of the two-year term of President Dr Tony Bartone and Vice President Dr Chris Zappala.

Dr Khorshid, an orthopaedic surgeon in Perth and a former AMA WA President, said governments should increase medical, health, and aged care expenditure to both combat COVID-19 and help the economy avoid prolonged recession.

“State and Federal Governments have rightly funded the response effort to COVID-19,” Dr Khorshid said.

“Yet the Victorian aged care crisis, that could so easily occur in any State, arises from years of underinvestment in nursing, general practice and specialist geriatric care in aged care services.

“The crisis in mental health, that will get worse the longer COVID-19 is with us, arises from decades of underinvestment.

“Nations that adopt austerity and neglect health spending during recessions have taken longer to return to economic growth, and their populations have been sicker.

“Yet where nations have increased health expenditure or directed stimulus funding to health care needs, their economies recover faster and populations have been healthier.

“Given my term as AMA President will see Australia living with COVID-19 and its induced economic downturn, I’m putting governments on notice it is time to spend, and not cut health.”

Dr Khorshid said his priorities for his term as AMA President are to:

  • Reaffirm the AMA as a strong, independent voice for health, with a critical role to hold governments to account, particularly on their handling of COVID-19;
  • Restart efforts to address financial sustainability of the Nation’s public and private health system, and to fully utilise and develop the quality and capacity of public and private care;
  • Halt the slide towards funder directed managed care;
  • Promote the value and cost effectiveness of high quality General Practice at the core of the health system and as a gateway to more expensive care;
  • Foster better gender equity within the leadership of the medical profession;
  • Seek action from governments and the community on important public health issues, including climate change and climate health.

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International collaboration on digital health best practice supports global response to COVID-19 pandemic

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[vc_row][vc_column][vc_column_text]The GDHP is currently chaired by India. Mr Lav Agarwal, Joint Secretary, Ministry of Health and Family Welfare, Government of India is the GDHP Secretariat Lead.

Mr Agarwal said “Sharing digital health information is now more important than ever as individual nations and the global community respond to the challenges of the COVID-19 pandemic.”

“These White Papers will provide both participant and non-participant countries and territories with guidance on the key digital health enablers that can lead in improving the health and well-being of citizens at national and sub-national levels through the best use of evidence-based digital technologies.”

The reports provide insights, guidance and information on cutting edge digital innovation for digital health workers, governments and organisations providing digital health services, and the communities they serve across the globe.

They are a valuable source of information that provide a catalyst for positive change, with insights and international comparisons of our digital health systems with countries around the world.

One key trend of GDHP members’ digital health systems are efforts to empower citizens to have greater involvement in the management of their own healthcare. This is evidenced in Australia in statistics published by the Australian Digital Health Agency which show consumers are uploading and viewing more of their My Health Record documents.

Chief Medical Adviser at the Agency and Chair of the Evidence and Evaluation work stream for the GDHP, Clinical Professor Meredith Makeham, said the Agency had supported and led the development of the White Papers over the past year, working with more than 30 countries from around the world.

“International collaboration is critical to improving health outcomes for all,” she said.

“Many countries and territories are still at the beginning of their digital health journey, so providing insights in key areas of common interest through our GDHP participation is fundamentally beneficial and supports our goals to improve health and well-being for people.”

“Our experiences with the COVID-19 pandemic have highlighted the importance of international engagement, and the critical role that digital health technologies play in ensuring that people have access to their healthcare providers and services. Digital health has never been more important.”

“I want to highlight the role Australia has played in establishing the GDHP as the inaugural Chair of the partnership and host of its first summit in early 2018. Since then we’ve benefitted from the opportunity to share valuable insights on digital health service delivery for our citizens that have been informed by the cutting-edge work of GDHP participants around the world,” she said.

Comments from other GDHP Work Stream Chairs:

Dr Don Rucker, National Coordinator for Health IT, US Department of Health and Human Services said “Sharing information using health data standards for interoperability is necessary to advance public health reporting and research which are key parts of an evidence-driven response to pandemics. Now, more than ever, increasing collaboration and sharing best practices around the world, not just within countries and territories, is critical to advance interoperability together globally.”

Shelagh Maloney, Executive Vice President, Engagement and Marketing, Canada Health Infoway and Chair Clinical and Consumer Engagement work stream said “Over the last decade there has been a universal shift in thinking; one where there was little to no support for providing citizens with access to their information, to present day, where we are accelerating efforts to provide citizens access to information in an equitable and secure manner. As governments around the world grapple with this new reality, and citizens in many jurisdictions are asked to remain home for public health, it has never been more critical for citizens to access their health information remotely: wherever and whenever it’s needed.”

The four GDHP White Papers are:

  • Advancing Interoperability Together Globally
  • Citizen Access to Digital Health
  • Benefits Realisation: Sharing insights
  • Foundational Capabilities Framework & Assessment

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Empowering Australians Through Health Literacy – Liz Carnabuci

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Carnabuci[vc_row][vc_column][vc_column_text]Health literacy is a significant issue for Australia. Digital health literacy – the ability to seek, find, understand, and appraise health information from electronic sources and apply the knowledge gained to addressing or solving a health problem – is at alarmingly low levels in Australia. It’s been said that almost 60% of Australians aged 15–74 have a relatively lower level on health literacy.

Why is this important? Because, low individual health literacy is associated with higher use of health services, low levels of knowledge among consumers and variable health outcomes. It has been estimated that people with low individual health literacy are between one-and-a-half and three times more likely to experience an adverse outcome. In an industry focussed on alleviating pain, restoring health and extending life – it’s all of our responsibility to improve literacy levels.

But how much is appropriate? Low health literacy in Australia will not be addressed if people cannot find the local, accurate and relevant information they need to make informed decisions with their healthcare professional – and ultimately, of course, decisions lie with the clinicians.

The Australian Commission on Safety and Quality in Health Care separates health literacy into two parts:

  • Individual health literacy – the skills, knowledge, motivation and capacity of a person to access, understand, appraise and apply information to make effective decisions about health and health care and take appropriate action.
  • Health literacy environment – the infrastructure, policies, processes, materials, people and relationships that make up the health system and have an impact on the way that people access, understand, appraise and apply health-related information and services.[i]

As an industry we can responsibly help shape the health literacy environment. It’s been estimated that one in every 20 Google searches is health related. Two in five Australians have used internet searches to avoid seeing a doctor (80% among 10-34), and 84% of people go online first for health information.

However, despite the high propensity to consume information, there is information asymmetry between providers and consumers. The consequence is an impact on decision making and reduced ability to access appropriate healthcare. This especially true of conditions which have an unfair stigma, or a complicated diagnosis pathway.

In an ecosystem where it is expected that companies will communicate with their customers and make information available, are we doing enough within the healthcare industry to promote accurate and relevant therapy-centric, community conversations on health? The way we adopt local advertising regulation holds the key.

To empower health literacy, advertising regulation must be consistent with the way consumers access and consume information – and we must adapt responsibly to it.  Responding to requests for information in public forums; engaging in public discussion; and, the provision of information to assist people make informed healthcare decisions are all part of a ‘brave new world’ to support consumers make informed decisions about their health. Ask yourself, are you doing enough to advance health literacy? How would you move this conversation forward – and let’s talk to improve health literacy for better patient outcomes.

[i] https://www.safetyandquality.gov.au/our-work/patient-and-consumer-centred-care/health-literacy

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ABOUT THE AUTHOR

Liz Carnabuci is the Vice President of Medtronic Australasia and Vice President Diabetes for Medtronic APAC.[/vc_column_text][/vc_column][/vc_row]

Virtual Healthcare needs to be part of a new-not old-health system – Alison Verhoeven

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H[vc_row][vc_column][vc_column_text]To limit virtual healthcare in this way is to squander the opportunity for healthcare reform and a better health system in the longer term – and that is the main message from our report, The effective and sustainable adoption of virtual health care.

 The current implementation of telehealth has certainly met some short-term and important needs in the health system – but to achieve lasting system transformation will require sustained policy efforts across big-picture areas such as funding, governance and workforce.

So far, we’ve substituted GP and outpatient clinic visits with phone calls and videoconferencing; we’ve made some limited foundational improvements such as e-prescribing; and in some places, such as in “virtual hospitals”, there has been some reading of tasks and processes.

However, a foreword-looking approach to virtual healthcare would involve planning to embrace the opportunities which may be available, for example, through remote monitoring, data-driven quality improvement, artificial intelligence and other innovations, to create new models of care.

To maximise the long-term benefits of virtual healthcare, we think some key areas of focus should be:

  • Patient-centredness, including codesign with patients, and measuring what matters to patients;
  • Equity, including proactive efforts to ensure affordability, equitable access to technology and digital literacy;
  • Cross-sector leadership and governance, across jurisdictions and the primary and acute care sectors, and in partnership with industry and researchers;
  • Digitally-capable health workforce development, prioritising team-based care and new roles needed to optimise integration of technology into health care;
  • Interoperability, standards and quality assured technology; and
  • Funding for reforms, including better use of data and evaluation.

Now – more than ever – as we face the most significant health and economic challenges experienced in a century, we need big-picture thinking and serious policy reform efforts that are agile and innovative.

We cannot shy away from disruptive thinking and the need to do business differently in order to achieve better rentals that take full advantage of the modern technologies available to us.

Equally, we should not sacrifice new thinking in order to maintain current healthcare practices, processes and professional interests.

You can read AHHA’s report on the effective and sustainable adoption of virtual healthcare here.[/vc_column_text][vc_zigzag][vc_column_text]

ABOUT THE AUTHOR

Alison Verhoeven is the Chief Executive of the Australian Healthcare and Hospitals Association, the national peak body for public and non-profit hospitals, Primary Health Networks, and community and primary healthcare services.[/vc_column_text][/vc_column][/vc_row]

Medibank Private and Bupa have failed Australians during COVID-19: CHOICE

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[vc_row][vc_column][vc_column_text]“Medibank Private and Bupa have failed Australians during COVID-19,” says Dean Price, health campaigner at CHOICE.

“The two biggest funds have performed the worst when it comes to helping Australians during COVID-19. The biggest funds should have the most capacity to help their customers, but instead they’re being shown up by not for profit and smaller funds who have less capacity, but have chosen to put the community first.”

“With people struggling during this economic and health crisis, people are keen to do what is best for their health and their finances, but Medibank Private and Bupa need to do a lot more to help Australians through this,” says Price.

Profiting from COVID-19

With reports earlier this month that insurers pocketed $1 billion in the space of 42 days, CHOICE says there’s no excuse for Medibank Private and Bupa to continue with price rises on October 1st.

“With Victoria in lockdown again and unemployment still rising, it’s just outright greed for Medibank Private and Bupa to charge Australians more on October 1st. These companies are saving massive amounts of money while people are unable to use many health services

– companies increasing prices is simply taking advantage of the situation,” says Price.

PR puffery versus real help

“CHOICE presented the five major health funds with five areas of COVID-19 support they could improve, with the simplest being transparency – publishing their hardship policies so people can find out what they’re entitled to and how to get help. Instead of telling customers what help they’re eligible for, Medibank Private and Bupa sent out media releases and continued to make people jump through hoops,” says Price.

“While their marketing departments have been quick to tell the community how they’re helping but our research has found a lot left to be desired in their COVID-19 responses.”

How did the rest fare?

“HBF came out on top of the list as they are the only fund so far that has cancelled this year’s premium increase,” says Price.

“In an example of industry leadership, HBF deserves to be recognised for its decision not to increase premiums in the middle of this pandemic. This is in stark contrast to the other funds who are increasing their premiums on 1 October. Other sectors, like banking and utilities, have recognised that the impact of this pandemic is going to be felt for a long time to come and extended their response beyond 1 October. The private health insurance industry needs to keep up with these industries who have acted more fairly,” says Price.

CHOICE is calling on private health insurers to:

  • Not increase premiums on 1 October
  • Give any windfall gains back to customers
  • Let people use any unused extras next year
  • Have hardship policies in place for people who have lost their job
  • Publish their hardship policies online

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MEDICAL RESEARCH FUTURE FUND NOW WORTH $20 BILLION

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[vc_row][vc_column][vc_column_text]The MRFF is an ongoing research fund announced by our Government in the 2014-15 budget. The target was to grow the MRFF to $20 billion through annual credits which are preserved in perpetuity.

The Government’s final credit of $3.2 billion will enable the MRFF to reach the historic $20 billion investment target just five years after the fund was established in 2015.

The capital of the MRFF is invested, with the earnings used to pay for important health and medical research projects, supporting Australia’s best and brightest health and medical researchers over the long term.

This investment is critical, particularly in light of the devastating impacts that the COVID-19 pandemic is having on so many Australians.

The MRFF is transforming health and medical research in this country. It will improve lives. It will save lives. At the same time, it will help build the economy, make Australia a global research destination, and make our health system more sustainable.

In the 2019–20 Budget, the Morrison Government announced a $5 billion, 10-year investment plan for the MRFF.

This plan continues our support for lifesaving research to develop new drugs, treatments, devices and cures. It gives researchers and industry certainty and direction, and reaffirms Australia’s reputation as a world leader in medical research.[/vc_column_text][/vc_column][/vc_row]

Edwards Lifesciences a finalist in five HR Awards categories

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[vc_row][vc_column][vc_column_text]This is the fourth year that Edwards has been recognised; this year, across five separate categories, up from one in 2019.

The winners will be announced on Thursday 3rd of December 2020.

Managing Director of Edwards Lifesciences ANZ and Korea, Pat Williams said:

“This is a fantastic achievement to be a finalist in five categories, which shows the strides we’ve made and the culture we’ve created locally. At Edwards, we aspire to excel as a trusted partner, fostering an inclusive culture where all employees grow and thrive.

“During these challenging times we have seen our employees having a laser focus towards our patient-centered Credo and every week we come together to celebrate those achievements.

“Our HR team deserves the recognition for delivering training and professional development programs across our ANZ organization.”

The finalists for some of the Australian HR Awards for 2020 is below.

Australian HR Awards finalists announced

Australian Business Lawyers & Advisors (ABLA) Australian HR Champion (CEO) of the Year
Annette Kimmitt, MinterEllison
Belinda Scott, Djerriwarrh Health Services
Hugo Schreuder, Youi Insurance
John Burns, VetPartners
Michael Azrak, MSD
Patrick Williams, Edwards Lifesciences
Richard Deutsch, Deloitte Australia
Simon McGrath, Accor Pacific

Randstad Australian HR Director of the Year
Fiona Reed, La Trobe University
Hannah Bloch, Gold Coast Health
Ivan Pierce, Youi
Julie Harris, VetPartners
Manon Pietra, PHD
Tash Macknish, Data#3
Yolanda Mallouhi, Edwards Lifesciences
Zahra Peggs, TSA Group

Best Health & Wellbeing Program
Camden Council
Data#3
Edwards Lifesciences
Johnson & Johnson
McDonald’s Limited
Mondelez
NSW Ambulance
QBE Insurance Australia’
Sanofi
Singleton Council

Employer of Choice (1-99 Employees)
Corporate Technology Services
DBM Consultants
Edwards Lifesciences
ghd hair
Howden Australia
PerformHR
Total Image Group

Achievers Best Reward & Recognition Program
Edwards Lifesciences
Employsure
Gold Coast Health
Insight
National Disability Insurance Agency
Youi[/vc_column_text][/vc_column][/vc_row]

MTPConnect to Deliver $47M Diabetes and Cardiovascular Disease Accelerator Program

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[vc_row][vc_column][vc_column_text]The announcement was made jointly by Hon Greg Hunt MP, the Minister for Health and Hon Karen Andrews MP, the Minister for Industry, Science and Technology.

MTPConnect said it will deliver a Diabetes and Cardiovascular Disease Accelerator (Accelerator) program to provide a new integrated research program to improve the management and treatment of diabetes and cardiovascular disease (D&CVD) in Australia.

The Accelerator will:

  • Establish research centres for diabetes and cardiovascular disease
  • Establish a contestable funding program to support D&CVD research projects
  • Promote the clinical and commercial translation of novel therapeutics and devices for D&CVD

The Accelerator will take a national and inclusive approach to working with clinicians, researchers, health administrators, Aboriginal and Torres Strait Islander health groups and consumers.

MTPConnect Managing Director & CEO, Dr Dan Grant, has welcomed the awarding of the program, through the Medical Research Future Fund (MRFF), which he says MTPConnect is uniquely placed to deliver.

“At its core, the MTPConnect Accelerator will stimulate collaboration across relevant industry, research and clinical organisations and leverage strengths across the sector to ultimately produce novel preventative interventions, diagnostic and therapeutic approaches and products for D&CVD that reduce the burden on patients, families and communities,” Dr Grant said.

“The TTRA program will drive a new focus on research efforts for the most pressing areas of unmet clinical and research needs in D&CVD, which are leading causes of death and disability in Australia.”

MTPConnect Chair Sue MacLeman says the MTPConnect Accelerator program will establish research centres for D&CVD across Australia, provide funding support and promote clinical and commercial translation.

“MTPConnect continues to make a valuable contribution to the growth of the MTP sector. Our Growth Centre work is now complemented by four Medical Research Future Fund programs worth nearly $147 million,” Sue MacLeman said.

“Through our work fostering collaboration, addressing workforce challenges, opening-up international markets and optimising regulatory and policy frameworks we are playing a key role to drive Australia’s health and economic wellbeing.”[/vc_column_text][/vc_column][/vc_row]

Medibank to pay $5 million in penalties for misrepresentations to members about benefits

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[vc_row][vc_column][vc_column_text]Medibank falsely advised 849 members with ahm’s “lite” or “boost” policies who had lodged claims or enquired about their coverage, that they were not covered for joint investigations or joint reconstruction procedures, when these policies in fact entitled them to coverage for these procedures. At least 1,396 enquiries or claims were incorrectly rejected.

Medibank admitted this breach occurred because it failed to include 186 joint investigation and reconstruction services in its claiming system for the ahm “lite” policy between February 2013 and July 2018, and failed to include 26 such services in its system for the “boost” policy between February 2017 and July 2018.

Despite Medibank identifying in June 2017 that some service codes had not been included, Medibank rejected 370 enquiries or claims over another 13 months, until the conduct ceased in July 2018.

The services involved included critical services, such as spinal surgery, pelvic surgery, hip surgery and knee reconstructions, as well as procedures on fibulas, elbows, heels, wrists, kneecaps and jaws.

“Medibank’s false statements to consumers were a serious breach of our consumer law. These representations were made for more than five years in many cases, and affected hundreds of customers who were denied the cover they were entitled to under their existing Medibank policies for joint procedures that they required,” ACCC Chair Rod Sims said.

“Some Medibank policy holders incurred extra out of pocket expenses for major medical procedures, some delayed having these joint procedures and managed their pain, while others ‘upgraded’ their Medibank policies at an additional cost when they didn’t have to.”

Medibank self-reported this conduct to the ACCC in August 2018 and has since notified about 130,000 current and former policy holders. It invited them to make a complaint or seek compensation. By 22 June 2020, Medibank had paid more than $775,000 in compensation to 175 affected members, including some who upgraded their policies unnecessarily based on the false information.

“Businesses who self-report breaches of the Australian Consumer Law are not exempt from ACCC enforcement action, but the penalties ordered by the court will take their cooperation into account,” Mr Sims said.

Medibank has undertaken to the ACCC that it will contact about 670 policy holders who have not already taken up Medibank’s offer for compensation and provide them with a further chance to claim. Medibank will also pay these members an additional $400 as a one-off payment.

Anyone who may be eligible will be notified by Medibank and will have six months to make a claim on the ahm website at https://members.ahm.com.au/joint-claims or can contact ahm on 134 246 or 1300 484 395.

Medibank has also undertaken to review its compliance procedures, and amend its incident management procedures.

Medibank cooperated with the ACCC’s investigation, admitted liability and made joint submissions to the Court with the ACCC.[/vc_column_text][/vc_column][/vc_row]