Case Studies: Health Insurance Providers

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Implementation of the Chronic Care Model using HCM delivers results

HealthChange Associates has partnered with numerous Australian Health Insurance Providers to embed behaviour change support into telephonic health coaching services.

Background: 

In 2014 Medibank sought to establish if a dedicated program – “CareFirst” – that supports and enhances usual chronic disease management in primary care could improve patient experience, self-management capability and quality of life, leading to improved disease control and reduced risk of hospitalisation. 

The program is now delivered by Amplar Health and in-house HCM training is a core element of professional development training.

HealthChange Associates Delivered:  

  • A program specific Train the Trainer program to enable ongoing delivery of HCM training in-house
  • Staff skills audit forms to monitor skills development
  • Co-creation of clinician scripts for recruitment, initial and review consultations
  • A framework to identify consistent Health Literacy messages
  • Co-creation of patient education materials
  • A Patient-Centred Care Plan and consultation documentation for data collection
  • A structure for ongoing skills development and a community of practice

Impact: 

Results of the 6-month pilot program were evaluated in 2018:

  • Improved participants’ clinical and health-risk indicators
  • Improved participants’ self-reported quality of life
  • Increased participants’ self-management capability
  • Reduced hospitalisation risk
  • Better disease control
  • Accepted as a feasible model of care

 “There is evidence that participants made changes to their health risk behaviours and as a result saw clinically significant improvements in blood pressure and quality of life, increased their ability to self-manage their condition and developed the confidence to continue with the changes they had made.” 

Tinning, R. (2018). Getting CareFirst right: A before and after evaluation of a complex "real-world" chronic disease management intervention [Doctoral thesis, Uni NSW]. https://doi.org/10.26190/unsworks/20551

Impact: 

 The Osteoarthritis Chronic Care Program (OACCP) compared their results to the previous year after implementation of HCM: 

  • Improved ability of patients to self-management: Surgical deferrals due to poor self-management reduced from 51% to 34% 
  • Reduced cardiac-related deferrals due to poor self-management alone declined from 29% to 10% 
  • High levels of patient engagement: Telephonic follow up with patients showed high levels of engagement and continued effective self-management, many avoiding surgery altogether 

Outcome

The CareFirst Program uses a consistent, evidence-informed delivery methodology that demonstrates how it implements the Chronic Care Model. Consistent person-centred service delivery is supported by in-house HCM training and skills development support. Use of HealthChange Methodology has contributed to the creation of a program that is highly acceptable to both participants and service providers. 

“More than 30 per cent of participants identified the time they had spent with the practice nurse as the best thing about the program.”