Medibank Health Solutions rejects Australian Medical Association assertions

Right of reply: Dr Matthew Cullen, Group Executive, Medibank Health Solutions

Dear Editor,

I was disappointed to read the article, “Battle looms over Defence health services” in Government News (Oct/Nov 2013) regarding our management of the ADF health contract in the press over the weekend and today.

I strongly disagree that Medibank Health Solutions (MHS) is “[failing] to live up to expectations in the management of [the] contract.” In the year since the contract commenced, we have experienced many successes and are now seeing what we believe to be an improved level of healthcare service for ADF personnel.

As you know, our contract provides Joint Health Command (JHC) with a single point to manage the entire healthcare needs of more than 80,000 ADF personnel.  It provides a new framework for healthcare delivery in Australia to ensure ADF personnel experience better health services, including access to on and off-base medical practitioners and allied health professionals, radiology, pathology and optometry services, as well as a 24/7 telehealth service delivering nurse triage, health advice and referral services.

We believe the contract delivers better and more timely healthcare for ADF personnel, while offering JHC a new, streamlined and efficient process, assurances over the access to and quality of health services for ADF personnel and improved reporting.

The new framework also improves visibility of government expenditure and provides greater certainty of costs.  For instance we have found in the past that some providers were charging excessive fees to ADF personnel, placing a significant impost on tax payer dollars.  In fact we have examples of doctors previously charging the ADF as much as 3 – 5 times AMA rates.

We take pride in ensuring that ADF members have access to an off-base specialist and other services when clinically required.
As at 1 July 2013, MHS had successfully delivered the following health services for ADF personnel:

•    838,000 on-base hours, allowing ADF Members to receive health services without having to travel away from their base
•    8,600 Health Hotline calls received, giving ADF Members access to a nurse anywhere, anytime for anything
•    194,000 pathology tests taken to help diagnose, prevent, treat and monitor diseases
•    49,000 imaging and radiology procedures
•    51,000 referrals processed via the Central Appointments Team for medical specialists and allied health providers anywhere in the country
•    75,000 invoices consolidated by ADFIT to make a single monthly bill for JHC
•    77,000 medical specialist services provided
•    45,000 allied health services provided
•    11,000 hospital services provided
•    66,000 rehabilitation assessments, helping ADF Members recover from injury and return to work
•    72,000 optical tests and items

We always anticipated, as would be expected with the implementation of any new model, that issues would crop up along the way and we have dealt with these in an open and timely manner.

The cost controls that we have put in place haven’t made groups like the AMA happy but it is the right thing to do for Australian taxpayers and is a powerful demonstration of how a transformation of government service delivery can deliver benefits to users and better value for taxpayers.

We all need to constantly innovate and look for new ways to deliver better health outcomes, improve patient experiences and to try to curb the ever increasing health costs our community is facing.  We think our ADF contract is an example of this innovation.

Dr Matthew Cullen
Group Executive
Medibank Health Solutions

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