Changing models of care – a snapshot

Hospitals and healthcare systems, both in Australia and around the world, face continued pressure to provide high quality services in a health environment characterised by funding constraints, rapidly rising costs, continuing access inequity, and increasing staff shortages.

All of these factors have enhanced the focus on - and necessity of - developing greater diversity in models of care, with an ongoing focus on healthcare models that are efficient, effective and more affordable.

The pandemic accelerated the rate of change in the health sector, forcing providers and other sector participants to innovate to adapt to delivery and systems pressures, with decades of change being implemented within 18 months. As part of these fundamental shifts, the adoption of new models of care was fast-tracked – seen particularly in the digital provision of healthcare and the increasing use of in home and community care models.

Health sector participants who were quick adopters of digital health systems and new models of care have reaped, and will continue to, reap the financial performance benefits. However, increasing digitization and changing models of care are also presenting challenges for some parts of the health sector, including private hospitals who have lost patients who are increasingly being taken out of the traditional hospital system. Increasing demand on the healthcare sector’s workforce, the biggest growing workforce in Australia, is also contributing to burnout among workers and consequent resourcing constraints, which are expected to continue. ^[1]

How these rapid changes in healthcare delivery and models of service provision impact on players in the sector over the medium term will depend to a large extent on whether they seek a return to pre-pandemic settings, or instead embrace the use of technology and new models of care – but ultimately the pace and scale of change in the healthcare sector will continue to provide opportunities for innovative players.

Below we provide a snapshot of some key trends in the changing models of care.

Digital engagement and virtual care

• By necessity, the pandemic greatly accelerated the adoption of tech-enabled healthcare, and it is here to stay - the “Reimaging Health Care” Consumer Survey ^[2] found that around 70% of Australians are ready and willing to use virtual health and over 80% are ready to share their health data in a digitally enabled health system. According to a health care executive survey conducted by Boston Consulting Group in late 2021, many providers believe that up to 60% of patient interactions for primary care will be conducted virtually in 3-5 years. ^[3]

• From telehealth and virtual care, to vaccine passports and electronic prescribing, there are innumerable examples of government funding programs and other initiatives supporting digital engagement in the health sector. These include:

• Telehealth given permeant status: the Federal Government committed $1.7 billion to ensure telehealth remains a permanent feature of Australia’s health system. As of 1 January 2022, the temporary Medicare Benefits Schedule telehealth arrangements became permanent. There are now more than 200 telehealth services covered by Medicare, providing digital access to general practitioners, consultant physicians, nurses, and allied health professionals.

• Increased mental health access: In the mental health space, there has been increased access to telehealth mental health services through the Federal Government’s Better Access initiative ^[4] and programs such as ‘Head to Health’, a collaborative initiative of Victoria’s primary health networks funded by the Federal Government, which provides a comprehensive electronic resource for people experiencing mental health issues or who support such an individual.

• Electronic prescriptions skyrocket: The use of electronic prescriptions, a digital version of a paper prescription which provides Australians with convenient access to their medicines, has also sky rocketed - according to the Federal government, as at September 2022 nearly 81 million electronic prescriptions have been issued since May 2020, by more than 48,000 prescribers (GPs and nurse practitioners). ^[5]

In home & community care

• Health sector participants, including governments, providers and payers, have also increased their focus on in home and localised community care models, including early supported discharge and hospital-in-the-home services. These models have a number of benefits, including assisting with managing capacity constraints and patient outcomes. Patients also show an ever-increasing preference to minimise hospital treatments and stays.
• The States and Territories have implemented various initiatives to provide care to public hospital patients in the comfort of their home, through hospital in the home programmes under which patients are still regarded as hospital inpatients and remain under the care of their hospital doctor.
• In the aged care space, the Federal Government’s $17.7 billion package to support aged care, includes $7.5 billion towards supporting senior Australians who choose to remain in their home and community, and the Commonwealth Home Support Programme facilitates seniors wishing to remain at home.
• In-home care is also an area of focus for private healthcare providers, with private hospitals increasingly partnering with other providers and payers to ensure efficient and seamless care, both in and out of clinical settings.

Please note that we have used external resources to contribute to the article.