1. Outsourcing for the Future
Presentation to the AHIA National Conference 2007
Mr Keith Joyce
Benefits Risk Manager
Medibank Private

2. 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.

3. 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.

4. National Health Recovery Agents
Who do we use?
National Health Recovery Agents
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.

5. The Statistics
Over 50,000+ transactions conducted by NHRA on behalf of MPL last Financial Year.
Zero Member/Customer Complaints.

6. The Journey so Far

7. Added Value Rates 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.

8. Traditional Intelligence Leads
TRADITIONAL LEADS
Members.
Providers.
Claims.
Solicitors.

9. Use of Intelligence Non Traditional

10. 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 %
*Source Australian Institute of Health & Welfare Canberra May 2007

11. Medical Negligence – A Comparative

12. 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.

13. 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.