Linda Swan

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Title

www.healthwaysaustralia.com.au

Innovations in Population Health

12th Annual Health Insurance Summit Dr Linda Swan Managing Director Healthways Australia Tuesday, 23 July 2013

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Population Health in Australia

What is the cost of doing nothing?

Innovations in Population Health

Leveraging Social media

Evidence of outcomes

Environmental Interventions

Content

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Population Health in Australia

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The Ultimate Goal is to Improve Well Being

Social/ Emotional

Financial

Community

Physical

Career

Health is a state of complete physical, mental

and social well-being

and not merely the

absence of disease or

infirmity.

- Preamble to the Constitution of the

World Health Organisation as adopted by the

International Health Conference, New York,

19-22 June, 1946

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Population Health

Population health is focused on understanding the health and disease in a community or population and

then developing interventions that can improving

health and well-being.

Fundamental to the approach is determining priority areas where investments should be focused to address

the disparities in health status within a population.

Encompasses a range of interventions including preventative health, supported self care, disease

management and integrated care

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Healthy & Good Health Habits

Wellness

Low Risk

Poor Health Habits

Prevention

support

Health & Lifestyle

Risk Factors

Prevention

support

Well-Managed

Condition

Supported

Care

Poorly Managed

Condition

Chronic Disease

Support

At Risk for Hospitalisation

High Risk Chronic

Disease support

High Risk

REQUIRES AN INTEGRATED HEALTH SUPPORT PLATFORM

Total Population Management

100% 50-60% 15-20% 5%

Active Care

Management

Prevention/ Risk

Management

Wellness Wellness programs designed to inspire

healthier lifestyles at each stage of life

Prevention Support Addressing lifestyle risks

that lead to chronic disease

Supported Self Care Periodic coaching,

education and support to allow self

management of conditions

Chronic Disease Support Active education and

encouragement to manage high cost chronic

conditions

High Risk Chronic Disease Support

Intensive one-on-one support for those at high

risk for hospitalisation

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Australian Government Priority Areas

Priority population groups

Indigenous people

Overseas born Australians

Rural and remote

Veterans

Socioeconomically disadvantaged

Prisoners

Priority age groups

Mothers and babies

Children

Young people

Older people

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Disease priorities

Cancer

Cardiovascular disease

Dementia

Injury prevention

Diabetes Mellitus

Asthma

Obesity

Mental Health

arthritis

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Recent Australian Government Initiatives

Australian National Preventative Health Agency (ANPHA)

Be the Influence - Tackling Binge Drinking

Donate life

eHealth

Fight Flu Campaign resources

Live Longer! - ATSI

National cervical screening program

National Seniors Productive Ageing Centre

National Skin Cancer Awareness Campaign

Quit for You - Quit for Two

STIs - Sexually Transmissible Infections

Swap It, Don't Stop It

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If there was a single map of activity

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The Cost of Doing Nothing...

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Months of expensive hospital

care can be undone by patients who just go home and go about

their normal activities.

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The Cost of Doing Nothing

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Health Status/Risk Matrix Australia

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Health/Risk profile determines the majority of future costs o HealthDo they have more, less, or average amounts of chronic

conditions (like obesity, diabetes, cancer, etc.)?

o RiskAre they more, less, or equally likely to engage in risky behaviors (like smoking, poor diet, poor stress management, etc.)?

Ris

k S

tatu

s

Health Status

Australia

High

Low

Healthier Sicker

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Developing a Simulation Model

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Vetting with the Framingham Heart Study

Segment Average risk Low risk Average risk Low riskMale 35-44 6.00% 3.50% 6.93% 3.60%

Male 45-54 12.50% 5.00% 13.80% 6.38%

Male 55-64 18.50% 8.00% 24.28% 11.13%

Female 35-44 1.50% 1.50% 3.00% 1.23%

Female 45-54 6.50% 4.00% 9.15% 5.28%

Female 55-64 12.00% 7.50% 20.23% 10.25%

Framingham Risk Scores Simulation Risk Scores Ten-year risk projection comparison

for the onset of coronary heart disease

Overall, our model, built on national

datasets (NHIS, MEPS, BRFSS) and

epidemiology data, projects similar to

slightly aggressive risk scores in

comparison to Framingham.

We build on this type of detailed-level

data to create population views in the

World Economic Forum Kiosk

Application

Simulation model developed by BCG and Healthways, with support of WEF

Goals

To assess the healthcare and productivity costs associated with

the most costly chronic conditions and behaviors

To show how the presence of a comprehensive well-being

program would affect future healthcare costs and productivity

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Medical Cost Growth

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Medical Costs grow over a five-year horizon o Without intervention, chronic conditions can be expected to progress more

aggressively than with intervention

o Costs are driven both by the communitys demographics and its Health/Risk profile

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Medical Cost/Health Condition Australia

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Medical Costs by Health Condition

o The top five conditions account for about 68% of all medical expenses.

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Productivity Cost

Productivity Costs grow over a five-year horizon

o The same conditions that require medical expenditures also contribute to lower productivity while an individual is at work.

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Productivity Cost/Health Condition / Australia

Productivity Costs by Health Condition

o Obesity alone is responsible for 37% of all productivity loss o The top five conditions account for about 71% of all productivity loss

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Opportunity for Doing Something Australia

Five-Year, Cumulative Cost Savings through Interventions in Modifiable Behaviors By introducing comprehensive well-being improvement programs that address all eight behaviors:

Medical Costs reduced by 11.60% Productivity Costs reduced by 8.21% Total Costs reduced by 9.69%

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Innovations in Population

Health

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Necessity is the mother of invention

Forward projections predict that healthcare costs will exceed revenue available between 2020 2050

70% of the burden of disease is due to chronic disease.

Our ageing population is living longer

Poor data: poorly controlled disease, waste and poor transitions/lack of coordinated care

1-2% of Australians drive around 50% hospital and medical expenditure.

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New models of Healthcare are needed

Current State Future State

Payment for Utilization

Fragmented Care

Patients

Episodic

Reactive

Variable Methods

Paper Intensive

Payment for Value

Coordinated Care

Populations

Longitudinal

Proactive

Evidence-based Care

Electronic

Guiding Principles

Use the lowest cost methods and modalities

Focus on interventions with proven outcomes

Ensure sustainable engagement of the individual.

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Innovations in Population Health

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Using data to drive decisions predictive modelling

Behavioural change to increase self management

Targeted programs focused on the 2%

Improved coordination/integration of care

Telemonitoring and telehealth

Ratio