Welcome to your September newsletter
It’s been a busy month for private health, and reporting season has given us plenty to think about. The results from nib, Bupa, Medibank and Ramsay each tell their own story, but together they point to a sector dealing with rising costs while looking for new ways to grow and create value.
That tension runs through this month’s newsletter. In one article, I’ve pulled out seven things the results tell us about where private health is heading. In another, I’ve taken a longer view, using the our PHI FACTORS™ to explore four possible futures for Australian healthcare in 2036. The question I keep coming back to is how much of that future we’re actively shaping, and how much will be decided by the incentives we leave in place.
The headlines make those choices feel more immediate. Healthscope’s break-up could change the balance of power between hospitals and insurers, while new approaches to menopause care and specialist navigation show what more useful support for members might look like. Further out, GLP-1s and wearable data raise questions about prevention, access and where insurers might create value.
That’s also why I enjoyed my conversation with Dr Margaret Faux. We talked about billing, payment models and the costs that are often difficult for consumers to see, despite ultimately landing with them. It’s a useful reminder that changing how care is paid for can matter just as much as introducing a new technology or service.
Of course, technology has a role in that future too. I’ve included a practical guide to ten AI use cases for private health insurers, covering opportunities from claims processing through to care navigation. The interesting question for me is where these tools can make a measurable difference for members and the people serving them.
Across everything in this edition, I see the same challenge: making decisions now that help private health work better in the years ahead. I hope it gives you a few useful ideas to take into your own conversations.
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