Transcript The TAC independence claims initiative

October 2011
Economic & social issues in providing LTC
Fiona Cromarty
Agenda
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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
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Background - Transport Accident Commission
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compulsory transport related personal injury
insurance
>
>
established by Transport Accident Act 1986
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owned by the Victorian Government
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“corporatised” – independent Board and management
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$8.3B assets, $8.5B liabilities as at June 2011
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approximately 800 staff
TAC Headquarters moved to regional city of Geelong
2009 (some smaller offices in Bendigo, Dandenong
and Melbourne)
>
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2015 Strategy
Corporate Goals in balance
Client
Outcomes
Scheme
Viability
Client
Experience
Background - TAC Divisions
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Financial &
Corporate
Services
Human
Resources
Business
Systems
Transformation
Claims Management
Business
Risk &
Intelligence
Claims
Claims
Model
Transformation
Support Services
2015 Projects
Collaborative
Community
Relations
IT Shared
Solutions
Health
Services
Group
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Background - Claims
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TAC wide
16,500 new claims accepted per annum
34,900 total claims managed
* as at December 2010
Independence
a
ty
b i l i 10 )
Liat 31/12/
Attendant Care & subs
support
$76M
$3,170M
Rehabilitation support
$26M
$480M
Income support
$24M
$420M
Dependant support
$63M
$300M
Total
$242M
$4,690M
(includes other support services provided)
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(as
o st
y c 0)
arl 201
Ye yments
·
600 new claims
p.a
5,300 total claims
managed
(pa
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Background – TAC 2015 Strategy
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Where we are aiming
to get to
Client
Experience
8.5 Client satisfaction score
VISION
A future where every journey
is a safe one
What our purpose is
MISSION
To work with the Victorian
community to reduce road
trauma and those it affects
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Strategic Goals
What we aim to achieve in 2015
to support us meeting our
mission and vision
Scheme
Viability
Client
Outcomes
$600 accumulated actuarial release
43.5 physical health survey average
47.7 mental health survey average
25% independence life area
objective achievement
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
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
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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)
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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?
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
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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)
Radical change will be required to meet
individual needs and expectations
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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
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