HCF drives ‘holistic’ short-stay joint program amid mixed stakeholder views

MedTech & Diagnostics News: In Australia, an estimated 120,000 patients undergo hip and knee joint replacement surgery annually, primarily for osteoarthritis. However, this journey often entails prolonged public hospital wait times or significant out-of-pocket expenses.

According to research spearheaded by Professor Ilana Ackerman, this figure is projected to double by 2030, attributed to factors such as an aging population, increased life expectancy, and escalating obesity rates.

“The increase highlights an urgent need for new and creative solutions, especially as healthcare costs continue to rise and delays in the public health system make elective surgery waits even longer,” stated Professor Ackerman.

Responding to these challenges, HCF, Australia’s largest not-for-profit health insurer, has collaborated with three Sydney hospitals and one in Melbourne to offer an affordable solution to patients.

Perspectives on short-stay joint replacement programs remain mixed, with stakeholders evaluating both barriers and facilitators to implementation and sustainability.

A nationwide study revealed that while health professionals and hospital administrators deem short-stay programs moderately feasible, it is moderately appealing to patients but of little appeal to carers. Common implementation hurdles include concerns over program appropriateness, inadequate home supports, and reimbursement issues or program funding. Patient worries often revolve around post-surgery pain management and mobility, while carers are primarily concerned about managing the patient’s daily activities.

HCF members are accepted into the program in line with clinical assessment criteria determined by the participating surgeon on a patient-by-patient basis. Maintaining continuity of specialist care in the chosen hospital, from admission to post-rehabilitation, is a core aspect of HCF’s No-Gap Joints program.

Julie Andrews, HCF’s Chief Officer of Member Health, said “This holistic approach helps members feel supported at every step of their journey.”

Despite this, questions remain about patient safety. An Australian systematic review and meta-analysis of short-stay programs for total hip and knee replacement concluded, “there is insufficient high-quality trial evidence to support the 90-day safety profile of short-stay joint replacement programs compared to usual care.”

However, Janet Novak, a Katoomba resident, attests to the program’s benefits, which not only covered her procedure expenses but also offered a choice of skilled surgeons and hospitals.

Almost one in five (19%) total hip replacement patients and nearly one in three (30%) total knee replacement patients are waiting over a year for surgery in the public health system, according to data from the Australian Institute of Health and Welfare.

“That can be a long time to wait when you’re in pain. Initiatives like HCF’s program are vital in helping to ease the strain on the public health system and improve patient outcomes,” Andrews emphasised. “By reducing out-of-pocket costs during and after surgery, and simplifying access to quality healthcare, HCF’s No-Gap Joints program allows members to focus on their recovery.”

Walter Kmet, Chief Executive of MQ Health, underscored the program’s importance in addressing financial concerns and improving access to quality care.

“Macquarie University Hospital is proud to be part of this initiative, offering our world-class orthopaedic unit to ensure patients receive the highest standard of care throughout their joint replacement journey,” Kmet said.

Since its inception in April 2021, the HCF No-Gap Joints program has assisted nearly 700 patients across New South Wales and Victoria, resulting in an average of $2500 savings for each member.

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