Let’s not forget the great work of private health

Amid the opposition and finger-pointing, let’s not forget the great work of private health

By Andrew Sando, CEO, Australian Health Service Alliances

I’m often asked why Australia’s health funds and private hospitals don’t work closer together.

For myself, and many others who see firsthand the work between our sectors, it’s hard to think where we don’t.

However, I concede, that as the finger-pointing and us-versus-them rhetoric (as seen across the Australian media in recent weeks and months) grows louder over the future of private health, some might doubt our collaborative efforts.

Nothing could be further from the truth.

“It is important amid times of heightened scrutiny that we champion the great work we are doing together. As an industry, private healthcare has much to address, but we have much more to celebrate.”

The majority in private healthcare know we are in it together, and – whether provider or payer – our job is to act in the interests of consumers. This means striving to provide care at the right time, in the right setting, and in the right manner – all while trying to make private health affordable for all.

As the country’s largest purchaser agent for not-for-profit private health insurers, AHSA sits at the centre of this equation, working between payers and providers to achieve the best results for Australian private patients.

An example of this emerged a few years ago, when we worked alongside one private hospital to address an unusual treatment anomaly.

Our data identified that patients presenting for a procedure in this particular region had a 22% chance of then being sent to the Coronary Care Unit (CCU). Anywhere else, the likelihood of being moved to the CCU following the same operations was significantly lower (closer to 12%).

No one wants to go to the CCU if they don’t need to; and it’s not the best use of our healthcare resources if it is unnecessary care.

Our insights were shared and validated with the region’s private hospital, and that hospital went on to work with clinical teams to investigate excessive CCU admissions and to establish new ways of working based on their own clinical assessments.

That private hospital could have very easily ignored the information AHSA gave them, but to the credit of the administrators and doctors, they confronted the anomaly and quickly adopted best practice based on other hospitals’ operations – including pre-operative and anaesthetic assessments.

For the patients at this hospital, our collaboration has led to improved pathways and fewer unnecessary admissions to the CCU. Now, this particular hospital is hitting state benchmarks, which is a huge achievement.

So why dwell on this? Because this is just one of many examples of how member-owned health funds and not-for-profit hospitals, and clinicians, work hand-in-hand to improve care delivery. We provide the data, insight and benchmarking to help them to improve and evolve.

More than that, it is important amid times of heightened scrutiny that we champion the great work we are doing together. As an industry, private healthcare has much to address, but we have much more to celebrate. We should not easily forget the work we do – every day – to uphold Australia’s reputation for world-class, quality healthcare.

About Andrew Sando

Andrew has unique experience and insights on how to be successful in healthcare, having during his career held Chief Executive and General management roles in private hospitals, pathology, medical centres and now working with Private Health Insurance funds. Andrew is the Chief Executive Officer of the Australian Health Service Alliance (AHSA), a role he has held for over 12 years. Prior to AHSA, he held multiple senior and strategic roles at Healthscope. He holds qualifications from Harvard Business School (Advanced Management Program) and a Masters of Business Administration to complement his initial Honours degree in Science.