The future of private

health insurance

Medibank today

2

Products &

services

PHI, travel insurance, life cover, pet insurance, health

management services, telephone and online health

and wellbeing services.

Customers

3.8 million PHI customers, state and federal

governments, area health services and district health

boards, corporate clients, 300,000 overseas students

and visitors.

Service delivery

188 points of presence including 99 retail centres, 46

agencies and 43 clinics.

More than 2 million telephone and online triage and

care management per annum.

Employees

(headcount)

4600 staff across all divisions and subsidiaries,

including almost 1800 clinical staff.

The future of private

health insurance …

what do our

customers want?

3

70% of this group

have underlying

chronic disease

Too often the focus is all about costs

Customers want their private health insurance to give them

four key things

Value

Simplicity

Flexibility

Relevance

The ‘ideal’ health insurance is focused on flexibility,

simplicity, relevance and value

The ‘ideal’ health insurance is focused on flexibility,

simplicity, relevance and value

Cover for the things that keep me happy,

healthy and functioning

Finding out about healthy living to stay healthy and

not use healthcare

Being able to choose the features that are relevant

to me today

I want to be covered for all family members and for all

impacts from ill health

Being rewarded for not having to use healthcare all

the time

See the person I want, when I want, with the same level of benefit

Knowing what I am up for, up-front

Being covered for the full expense, not gap, no payments on the day

And private health insurance becomes especially

important when customers are managing major life

changes ...

Once I had kids, I realised that we

all needed the best protection…

You just don’t want to be left managing the unknown …

Customers view health insurance differently to other

insurances ... there is an expectation it will provide a better

standard of healthcare

NON-HEALTH INSURANCE

If your possessions are lost

or damaged insurance

compensates you for it.

This type of insurance is all

about keeping the status

quo/not losing anything.

PRIVATE HEALTH INSURANCE

Health is a personal and individual thing – there are many shades of grey.

Health insurance is about protecting and looking after myself.

Health insurance is about getting a better and more superior healthcare outcome.

Private health insurance should allow me to look after my

health as I choose …

Reduce the

burden on the

public system

To provide quicker

access for some

non-emergency

services …

To provide greater

financial coverage

for some medical /

health services

To provide better

quality healthcare

experiences

(non-medical)

Customers wanted us to help them with their health

A new service; a change in how

we interact with our members.

The first integration

exercise - insurance

and health solutions.

The Effect

The healthcare challenge

…while our ability to pay is reducing

Source: IGR2010

The Effect

Significant change possible

through better intervention…

Cost at current health

system trajectory

Healthy and

productive population

…but with behavioural

modification and better

management

Medibank’s purpose has changed from health insurance to

health assurance

Health Solutions

For Bet er Health

Private Health Insurance

Total Health

t

Building an integrated health business structure

‘The Medibank Effect’

Private

Funding

Medib

ank P

rivate

Private

Funding

Building an integrated health business structure

‘The Medibank Effect’

Private

Funding

Medib

ank H

ealth S

olu

tio

ns

Medib

ank P

rivate

Private

Funding

Public

Funding

Building an integrated health business structure

‘The Medibank Effect’

Private

Funding

Public

Funding

Medib

ank H

ealth S

olu

tio

ns

Medib

ank P

rivate

Private

Funding

Building new gateways

New healthcare platforms

New models of care

A network of

trusted providers

Reduced costs

Better patient

outcomes and

experience

Contracted Provider Networks

Gateway Navigation and Referral

Increased efficiency

Access to the

right care

At the right time

New Healthcare platforms …

Anywhere Healthcare

Today is

suddenly a

much better

place

Integrated care co-ordination…

A more efficient process

1. Continuity of care

across secondary

and primary sectors

2. Continuity of

patient information

and support

3. Co-ordination

of providers

“Care Team”

Self navigating the system

Random care

Random care

Coordinated care

The Effect

Coordinated care

Future: Integrated health system (eg ADF)

One telehealth nurse can support over 6,000 patients

30

Dental and Optical cl inics Telephone triage

Disease management

and health coaching

Immigration / Visa Medical

anywhere ><healthcare

Anywhere Healthcare

Workplace Heal th

Garrison Health

Travel Doctor

MHS and PNIC businesses:

Now Medibank members are seeing the benefits of

integrated health services

31

A healthcare system for the future

Patient and

care team

Individual

care plan

Focus on diet,

exercise and healthy

behaviours

Patient has

responsibility for

their own health

Thank you.

Any questions?