Summary of Meeting 4 of the Improved Models of Care Working Group 9 October 2018

Page last updated: 31 October 2018

Summary of Meeting 4 of the Improved Models of Care Working Group 9 October 2018 (PDF 132 KB)

Attendees

MembersMembers – via teleconference
Dr Jeffrey Harmer AO, ChairDr Andrew Wilson, Medibank
Janne McMahon OAM, Private Mental Health Consumer Carer NetworkMarcus Dripps, Allied Health Professions Australia
Jo Root, Consumers Health ForumInvited Guests
Andrew Sando, Australian Health Service AllianceLucy Cheetham, Australian Private Hospitals Association
Christine Gee, Australian Private Hospitals AssociationDr Andrew Singer, Chair, Rehabilitation Sub-Group
Professor John Horvath AO, Ramsay Health CareSecretariat
Dr Stephen de Graaff, Australasian Faculty of Rehabilitation MedicineSusan Azmi, Secretariat
David Whelan, Secretariat
Kate Jarvis, Secretariat

1. Welcome and introductions

  • The Chair opened the meeting, noting those members attending via teleconference and the invited guests. The Chair also noted the members who were apologies for the meeting, those were:
    • Belinda Highmore, Mental Health Australia
    • Kelly Johnstone, Bupa
    • Peter Bailey, Wyndham Clinic Private Hospital
    • Associate Professor Graham Mercer, Australian Medical Association
    • Professor Ian Hickie AM, Brain and Mind Centre, University of Sydney.

2. Verbal update on reforms

  • The Secretariat gave an update on the progress of private health insurance reforms, including the passage of legislation, the Ministerial Advisory Committee on Out Of Pocket Costs and changes to second tier arrangements.

3. Private health insurance legislation

  • The Secretariat presented a paper, requested at previous IMOC meetings. The paper was intended to clarify the private health insurance legislative arrangements, as they relate to regulating models of care.
  • Members agreed that this document helped clarify the legislative arrangements, especially as they differentiate between treatments provided by a hospital outside the hospital’s physical boundaries (commonly called hospital in the home) and hospital substitute treatments. Members agreed this document should be presented to the Private Health Ministerial Advisory Committee (PHMAC) as an example of ways to communicate the legislative arrangements to industry stakeholders.
  • The document included high level differentiation of treatment types and the relationship between treatment type and funding arrangements. Members agreed that this document should also be presented to PHMAC.
  • Members asked that additional information about the boundary between public funding, private insurance and self-funding be added in advice to PHMAC.

4. Final Reports for Mental Health and Rehabilitation Sub Groups

  • Dr Andrew Singer, Chair of the Rehabilitation Sub Group, presented the final report from that sub-group to IMOC. He outlined the main findings and recommendations of the sub group.
  • Ms Christine Gee, member of IMOC and the Mental Health Sub Group, presented the final report from that sub-group to IMOC. She outlined the main findings, noting the similarities and major differences from the other sub-group report.

5. Literature reviews

  • Two literature reviews conducted by the Secretariat were presented to IMOC. IMOC agreed that the literature reviews were useful background documents but that there is not a significant body of directly relevant literature to inform IMOC’s recommendations to PHMAC.

6. Application to other clinical areas

  • Members were asked to consider which recommendations or key findings for rehabilitation and mental health could be extended to other clinical areas.
  • Members generally agreed that they were not in a position to make specific recommendations, but that the principles used to guide IMOC’s work should be used as the basis for future considerations of improving models of care.

7. Use of incentives to encourage uptake of alternative models of care

  • IMOC was advised that both sub-groups found that regulations did not currently prevent alternative models of care. It is also clear that the uptake of such alternatives is low.
  • Members were asked whether there were ways alternative models of care should be incentivised through regulation.
  • Members agreed that incentives are not appropriate as they may distort the natural evolution of models of care. However, they noted that while regulations did not prevent alternative models of care there were some issues which may discourage them. IMOC agreed that these should be highlighted to PHMAC.

8. Other Business