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Outsourcing for the Future Presentation to the AHIA National Conference 2007 Mr Keith Joyce Benefits Risk Manager Medibank Private
What are the Benefits to Outsourcing? • Savings of FTE positions –Equivalent 16 FTE. • FTE’s can be returned to core business functions. • Reduced on costs/overheads. • Use of specialist expertise & services. • Network with professional organisations eg Australian Lawyers Association, Leading National Law Firms. • Low impact at customer level, improved service and delivery of service.
Recoveries • Common Law & Medical Negligence Compensation. • Growth area for compensable recoveries – medical indemnity & increase in litigious society • Medibank Net rate of return has increased 12 fold. • Major areas include class actions, product liability (prostheses) & asbestosis.
Who do we use? • NHRA has 40% Insured Market Share Australia Wide. • Industry Knowledge, Specialist Skill Set & Contacts. • Innovative and Market Leader. • Quick reaction to current issues. • Greater returns, lower costs and quicker results than using traditional process eg- court/legal strategies.
The Statistics • Over 50, 000+ transactions conducted by NHRA on behalf of MPL last Financial Year. • Zero Member/Customer Complaints.
The Journey so Far
Added Value Rates of return guaranteed for every dollar accrued. • Before outsourcing less than 30 Cents in the dollar. • Now Increased to over 70 Cents in the dollar.
Traditional Intelligence Leads TRADITIONAL LEADS Members Or Providers • Members. • Providers. • Claims. Traditional Leads • Solicitors. Claims Solicitors
Use of Intelligence Non Traditional Legal Network Professional Associations Media/Courts
Medical Indemnity Claims in Australia 2004 -05 • Common incident/allegation type leading to a claim: • Procedure 30. 5% • Diagnosis (23. 6%) • Treatment (13. 2%) • Age Demographic of those affected: • Babies <1 yr Old 3. 6% of new claims • Children <18 yrs old 5. 0% of new claims • Adults 18+ 61. 7% *Source Australian Institute of Health & Welfare Canberra May 2007
Medical Negligence – A Comparative
Case Study: Medical Negligence • Member contracted severe secondary infection while in emergency at a major hospital. • Subsequent amputations and reconstructive surgery were required. • Negotiations resulted in an out of court settlement reached. • Medibank Private obtained restitution agreement of in excess of $200, 000 to cover the payment of past medical expenses. • Case management of more than 3 years involving negotiations meetings with member, solicitors and medical professionals.
Summary • Rates of return outweigh managing in house. • No interruption to the business interface. • Increased cash flow. • Greater Returns. • Company able to focus on core business. • Improved customer outcomes.