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Hospitals Contributions Fund (HCF)

A chronic disease management program launched three years ago by Australia’s largest not-for-profit health insurer, the Hospitals Contributions Fund (HCF), has been found to significantly reduce the rate of hospital admissions for participants with heart disease and diabetes. The My Health Guardian program leads to reduced healthcare costs by helping people with chronic diseases self-manage their conditions. Published in the peer-reviewed journal, Population Health Management, the program’s impact on hospital admissions is reported in a first-of-its-kind study in Australia . These significant changes in healthcare utilization are indicative of improved population health and lead to reduced healthcare cost.

An evaluation of the program compared more than 5,000  My  Health Guardian participants suffering from chronic heart disease and diabetes with a statistically comparable group of more than 23,000 non-participating HCF members with the same two conditions. Rates of hospital admission and readmission and the average length of stay (ALOS) were measured for both participating and non-participating groups over one year prior to the program’s commencement (as baseline), and again after the first 12 and 18 months of the program’s operation.

“The study bolsters the case for investment in effective chronic disease programs,” said HCF Managing Director Shaun Larkin. “Chronic illness accounts for 70% of Australia’s national disease burden today, and this is expected to increase to 80% by 2020. If we are serious about easing the strain on our health system, we need to gather evidence on programs that work. My Health Guardian offers a template for the way forward.”

Among key findings of the evaluation:
  • The program participant group (heart disease and diabetes) uniformly recorded lower hospital admission and readmission rates and ALOS than the non-participating group, after both the 12-month and 18-month period.
  • For participants with heart disease, the difference in percentage change in hospital admission rates compared to non-participants was -7.2% and -12.0% after 12 months and 18 months respectively. This participating group also recorded statistically significant improvement in readmission rate after 12 and 18 months and ALOS after 18 months compared to non-participants.
  • For diabetes sufferers, the difference in percentage change in hospital admission rates was -7.8% after 12 months and -13.4% after 18 months for program participants compared to non-participants.
  • The outperformance of program participants versus non-participants on all measures widened the longer they were in the program.

Launched as a A$100 million investment by HCF, My Health Guardian offers support to members suffering from up to 12 chronic conditions, including diabetes and heart disease, which together account for the bulk of chronic illness in Australia. The program is delivered by population health provider Healthways and includes care management calls, personalized online health support, regular health assessments, health action plans and tracking of health behavior.

“Another significant implication of this study is the successful adaptation of a program model pioneered in the United States to improve outcomes in the context of the Australian culture and healthcare system,” said Dr. James Pope, M.D. F.A.C.C., co-author of the study and vice president, Chief Science Officer at Healthways. “We were very pleased with the rates of participation among HCF members and the program’s strong outcomes. These results suggest comprehensive chronic care programs could by adopted by other countries that are experiencing rising prevalence of chronic disease along with the significant accompanying increase in medical expenditures and decrease in quality of life.”

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