Who is Honeysuckle Health?
Honeysuckle Health is a joint venture between nib Group and Cigna Corporation. Our purpose is to create “better pathways to better health” for Australians and New Zealanders. We believe we can do this by creating a “better connected health system”.
We take a data science led approach which ensures that we can predict and help prevent disease of customers as well as measure outcomes and values across the healthcare value chain for funders. Our goal is to establish ourselves as a "utility" for healthcare funders.
On what principles was the business established?
The business was established on four main principles:
- We believe there is an opportunity to invest more in primary care and preventative care to avoid the development and progression of chronic disease into conditions requiring hospitalisation.
- We believe both private and public healthcare funders must develop better relationships with primary healthcare providers, general practitioners (GPs) in particular.
- We believe incentives in the healthcare system must align with improving value and outcomes that matter to patients.
- Investments made to improve an individual’s health need to be backed up by evidence to ensure they are effective and appropriately directed to support the sustainability of the healthcare system into the future.
Following these principles will lead to better health outcomes for individuals and communities and reduce healthcare funders' costs to ensure Australia has a viable, high quality and affordable healthcare system.
What services does Honeysuckle Health provide?
We offer a range of tailor-made healthcare analytics services for health insurance providers. Our leading team of data scientists work in conjunction with artificial intelligence and machine learning platforms to deliver these programs and services. For more information on our healthcare analytics services, click here
We have developed a number of telephonic health programs delivered by Registered Nurses to support the health needs of our clients’ members. These include a hospital discharge support program, a chronic disease care coordination program and mental health support programs.
These programs have been designed to support individuals care coordination between hospital and primary care to ensure they get the best possible outcomes. Our nurses are a readily accessible source of support for patients in need. Although these programs are still new, we are developing strong evidence that the programs are clinically and cost-effective. Feedback from patients has been overwhelmingly positive. For more information on our Health Management Programs, click here.
We are also building relationships to offer digital health programs to our clients. In June 2021, we launched our first digital partnership with Limber Health. Limber provides at-home physical therapy for a range of musculoskeletal conditions, including lower back, shoulders, hips, neck, and knee joints. Limber gives users access to a home exercise program tailored to meet their health needs.
Health Service Contracting
Our Health Service Contracting team contract with providers to deliver value-based care, and to support decision making of individuals and healthcare providers. For more information on provider networks managed by Honeysuckle Health, click here.
How does the Clinical Partners program work?
Our Clinical Partners program collaborates with participating orthopaedic surgeons and their surgical team to ensure patient's do not have any medical out of pocket expenses for hip and knee joint replacement. Where deemed clinically appropriate by the surgeon, patients can recover in the comfort of their own home with support from allied health professionals or other forms of care and technology. Participating patient and clinician feedback from the program has been overwhelmingly positive.
We see great opportunity in expanding the Clinical Partners program to more specialties and procedures. The Clinical Partners program is based on care delivery specific to the medical practitioners’ preferences and is supported by our care coordination team.
Why has Honeysuckle Health established a buying group?
In line with our purpose, we believe all Australians should have access to innovative and outcome-based care options. The best way to achieve this goal is to ensure that we can offer our range of services to healthcare funders who wish to enable access for their members to these services.
To support these ambitions, and with our foundation client, nib health funds, we have established ourselves as a buying group through formal authorisation with the Australian Competition and Consumer Commission (ACCC) for other healthcare funders. This will allow healthcare funders to share the costs associated with negotiating and administering contracts and more confidently target funding towards products, services and programs that effectively prevent, manage, and treat disease risk.
Several health-focused buying groups exist in Australia, including the Australian Health Service Alliance (AHSA) and the Australian Regional Health Group (ARHG). We believe our key points of difference to these groups will be our focus on value-based care and the use of data science to inform decision-making.
Health insurance is adapting rapidly to the increased demand from members for better value. We see that many smaller healthcare funders may be left behind if they don't have better options and services from a range of buying groups. Our establishment as a buying group in this market will give smaller funds more options and improved services (from all buying groups) to compete with larger healthcare funders.
What conditions were imposed by the ACCC on the Honeysuckle Health buying group?
The Australian Competition and Consumer Commission (ACCC) has issued its final determination authorising Honeysuckle Health to form and operate a health services buying group for five years.
The authorisation includes conditions limiting the size of the buying group which means that none of the major PHIs (defined as Medibank Private, Bupa, HCF and HBF in WA) are permitted to join the buying group.
The conditions imposed by the ACCC apply to the activities of the buying group, i.e. collectively negotiating and managing contracts with healthcare providers.
Is Honeysuckle Health looking to intervene in the clinical relationship between doctor and patient?
No. Honeysuckle Health has no intention to ever interfere in the clinical autonomy of doctors. Instead, we are looking to provide optional tools, services, and funding model to enhance the care medical providers already provide.
It’s also important to note that contracting between health insurers and providers is governed by the Private Health Insurance Act (2007) (Act). This regulation means that health insurers by law are unable to interfere in the clinical relationship between doctor and patient and cannot direct doctors to provide care.
We do intend to create new relationships with medical specialists to recognise, reward and encourage them to deliver better value and outcomes to patients. Value-based contracting is being adopted by most developed countries and, in Australia, NSW Health is leading the introduction of value-based care.
Will Honeysuckle Health be able to access My Health Records? If so, why is this access needed?
Honeysuckle Health is registered with the Australian Digital Health Agency as a provider organisation.
We employ registered nurses to provide a range of telephonic Health Management Programs to patients who are members of participating health funds. These clinicians access the My Health Record of individual patients to obtain information that can support clinical decision making, but only after the clinician has received the express consent of the patient to do so.
We do not access My Health Records for any other purpose.
What is value-based care?
Value-based care is a belief that the fundamental goal and purpose of healthcare should be to improve value for individuals and that delivering high-value healthcare is the definition of success.
Value-based care is defined as:
Value-based care is not new, with many healthcare systems globally exploring how to apply it, including NSW Health more locally. A key ingredient to shifting the system from volume-based care (or fee-for-service care) to value-based care is defining what health outcomes matter to individuals and then measuring whether those outcomes are being achieved.
There’s plenty of information available publicly about value-based care. A good place to start is this presentation by Michael Porter from the Harvard Business School which was made to the OECD. Click here to view.
Why do health insurers want to know more about their member’s health?
Health insurers worldwide are seeking to provide better value to their members, transforming from ‘healthcare payers to healthcare partners’. To be an effective health partner, health insurers want to personalise products and services based on each member’s specific needs. The more a health insurer understands about a member’s health status, the more effectively they can personalise or tailor solutions that will help their members improve their overall health and well-being.
Will this lead to higher health insurance premiums?
No. Many consumers are fearful that insurers will use this information simply as an excuse to charge them a higher premium. These fears are unfounded since health insurance in Australia is ‘community rated’. This means that it’s illegal for insurers to refuse cover or vary the premium charged to a person based on their level of risk of requiring future treatment, age, gender, race, sexual orientation, health, religious beliefs, family size and any other reason.
'Community rating' applies to all health funds in Australia, and its purpose is to ensure 'equity of access' to health insurance for all Australians. Health insurers must charge the same premium for the same product to all consumers.
What is nib’s and Cigna’s relationship to Honeysuckle Health?
Honeysuckle Health has been established as a separate company, with nib and Cigna each owning 50% of the business. Honeysuckle Health operates independently to nib and Cigna and has a local management team and workforce. nib is also Honeysuckle Health’s foundation client in Australia and New Zealand.
Who is nib?
nib Group (nib) is a trusted international health partner, that empowers its members to make better decisions and improve health outcomes through greater accessibility to affordable health services and information.
nib provides health and medical insurance to over 1.6 million Australian and New Zealand residents as well as more than 190,000 international students and workers in Australia.
Who is Cigna and why have you partnered with them?
Cigna is a global health services company dedicated to improving the health, wellbeing, and peace of mind of the populations it serves by making healthcare simple, affordable, and predictable. With over 180 million customer and patient relationships in more than 30 countries and jurisdictions, they are able to harness actionable insights that address whole-person health and drive better health outcomes. Cigna has created significant capability in health services and value-based contracting that they believe will benefit consumers in healthcare markets globally, including Australia.