Private health insurance initiatives in chronic disease management: Fragmentation or progress?

Pharma News: The country’s largest not-for-profit health fund, HCF, has joined forces with The Victor Chang Cardiac Research Institute in offering complimentary heart health checks to HCF members holding hospital and extras cover.

“Heart disease is a significant health concern, with around 57,000 Australians experiencing a heart attack each year,” highlighted Linda Opie, HCF’s Head of Health & Wellbeing. “However, by taking proactive measures like understanding individual risk factors and monitoring heart health, many cases can potentially be prevented.”

“Prevention, detection, and effective treatment are our best weapons against heart disease and stroke,” emphasised Professor Jason Kovacic, cardiologist and the Director and CEO of the Victor Chang Cardiac Research Institute. “By quitting smoking, eating a nutritious diet, and engaging in the right kind of exercise, improving your heart health can be relatively simple for most people.”

The heart health check process, administered by specialists from the Victor Chang Cardiac Research Institute, takes less than 10 minutes and evaluates key risk factors including blood sugar, total cholesterol, and blood pressure. Participants receive a personalised heart health snapshot along with recommendations for maintaining a healthy lifestyle. Upon identification of risk factors, participants are referred to other free HCF Health & Wellbeing programs, encompassing weight loss, cardiovascular disease and diabetes management, and mental health support.

The RACGP position statement on the role of private health insurance emphasises the integration of private health services with GP-led care. Services already being provided by a patient’s usual GP, such as chronic disease management, should not be duplicated by private health insurers, as this will lead to fragmentation and inefficient use of health resources.

“Private health insurance pilot projects or programs must not result in patients who are insured being given priority or preferential access to primary healthcare services over patients without insurance who may have greater need. The RACGP supports equity of access to services for all patients regardless of income or insurance status,” the statement emphasised.

“I have a history of high cholesterol in my family, but I never thought it would be an issue for me,” Patricia Wade, a patient who took the heart health check, confessed. “I’m young, rarely drink alcohol, and I’m quite active, so I’m a bit shocked.”

Recent data from HCF members in Maroochydore shed light on the efficacy of the initiative. A staggering 96% admitted they were unaware of their total cholesterol levels prior to the heart health check, with an even higher 98% oblivious to their blood sugar levels. Moreover, nearly eight in ten (77%) members tested showed results outside the healthy range, prompting urgent follow-up with their GPs.

“Heart health checks empower people with immediate insights into their heart health status, enabling them to make informed decisions and take proactive steps towards a healthier future,” Ms Opie affirmed.

Currently available at select HCF Eyecare Centres, Dental Centres, and branches across New South Wales, these complimentary heart health checks will also roll out in the Australian Capital Territory, Western Australia, Victoria, and South Australia in the coming months.

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