Economic & social issues in providing LTC

Fiona Cromarty

October 2011

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> TAC Background> Drivers for change> Independence Model> Early signs of success> Challenges yet to be solved

> Where to next…our vision

Agenda.

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> compulsory transport related personal injury insurance

> established by Transport Accident Act 1986

> owned by the Victorian Government

> “corporatised” – independent Board and management

> $8.3B assets, $8.5B liabilities as at June 2011

> approximately 800 staff

> TAC Headquarters moved to regional city of Geelong 2009 (some smaller offices in Bendigo, Dandenong and Melbourne)

Background - Transport Accident Commission.

2015 StrategyCorporate Goals in balance

ClientOutcomes

ClientExperience

SchemeViability

Background - TAC Divisions .

BusinessSystems

Transformation

Financial &CorporateServices

HumanResources

BusinessRisk &

Intelligence

CommunityRelations

HealthServicesGroup

Claims

IT SharedSolutions

ClaimsModel

Transformation 2015 Projects

Collaborative

Support Services

Claims Management

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Background - Claims.

TAC wide16,500 new claims accepted per annum34,900 total claims managed* as at December 2010

Dependant support

$76M $3,170MAttendant Care & subs support

$26M $480M

Income support $24M $420M

Rehabilitation support

$63M $300M

Independence

Total(includes other support services provided)

$242M $4,690M

· 600 new claims p.a

· 5,300 total claims managed

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Background – TAC 2015 Strategy.

VISIONA future where every journey

is a safe one

MISSIONTo work with the Victorian community to reduce road trauma and those it affects

Where we are aiming to get to

What our purpose is Strategic Goals

Client Experience

Client Outcomes

SchemeViability

What we aim to achieve in 2015 to support us meeting our

mission and vision

$600 accumulated actuarial release

43.5 physical health survey average47.7 mental health survey average25% independence life area objective achievement

8.5 Client satisfaction score

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Drivers for change in Independence

Liabilities increasing rapidly – Attendant Care and substitutable services costs are predicted to continue growing

Claims Management weren’t focused on Client Outcomes – what was all the expenditure of benefits really achieving?

Client Satisfaction was plateauing – Clients are increasingly aware of their rights

Growing need for a holistic planning approach – no coordination of treaters

‘It’s not our liability but is it our problem?’

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The Independence Model at a glance…

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The Independence Model

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Phase 1: CURRENT

• Early Support Team: Manages all new Independence claims, one point of contact providing face to face service and all decision making. Leads development, implementation and tracking of Independence plan.• New claims management tools• Revised communication products for clients and providers• Streamlined discharge process for attendant care services• Pilot outcome measures

Phase 2: From December 2011

• Independence plans introduced for current clients• Clearly identified client goals that support improving independence wherever possible• Funded support services linked to client goals• Collaborative planning process involving clients, providers and the TAC• Measurement of goal attainment • Client outcome measures that are standardised and measure changes in well-being and community integration

Evaluation of Independence model Research collaboration with ISCRR will conduct a process, impact & outcome evaluation of the Independence model (five year program)

– Process: are the Independence initiatives being implemented as intended?

– Impact: is the Independence model increasing the capacity of the TAC to respond to client, provider and organisational needs and is there a consequent improvement in the underlying determinants of desired outcomes?

– Outcome: have the Independence initiatives led to improved client outcomes, client experience, scheme viability and claims management efficiency and effectiveness?

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Early signs of success

‘Getting to know the clients and their families so early post accident allows for the development of trust. This then enables us to encourage families and clients to see their potential for independence in what ever shape of form that may be’.

Early Support Coordinator – Sarah Bull

Other challenges – not yet solved

The needs of individuals change over time

Attendant Care sector • Workforce demand and supply• Alignment to Independence philosophy National Disability Insurance Scheme (NDIS) and National Injury Insurance Scheme (NIIS)

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Radical change will be required to meet individual needs and expectations

What else are we doing?

Accommodation

Sector wide demand and supply issues for accommodation

TAC has established Residential Independence Pty Ltd (RIPL) Property Trust

RIPL will develop accessible accommodation across the state, setting new benchmarks in universal design

Current Projects include:

Six independent living units in Lilydale

Sourcing suitable land to meet TAC’s current areas of need in Melbourne’s outer suburbs and regional areas

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What else are we doing?

Provider Strategy – Independence as part of TAC independence projects will support clients in their journey towards independence, in line with the strategic objectives of TAC 2015 – client outcomes, client experience, and scheme viability

The Strategy focuses on key components – all interrelated: Developing and implementing new service models – attendant care and accommodation

Capability and capacity

ABI and behaviours of concern

Developing partnerships

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Where to next….our vision

> Online capability enabling interaction between the client, TAC and providers

>All services align to client goals

>Range of service options available to meet all individual needs

Our clients are empowered and enabled to achieve greater independence and better health, vocational

and quality of life outcomes