What healthcare gap participation transparency means for patients
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What healthcare gap participation transparency means for patients

The difference between expectation and reality when it comes to health insurance coverage is a growing concern. In this article, we take a look at how we can ensure greater transparency when it comes to healthcare gap participation and what it means for patients.

Upfront information reduces the chance of ‘bill shock’

Although cost is only one factor to consider when making decisions about our health, it is certainly an important one for many Australians. Free and easy access to cost, insurance and treatment options can inform GPs about gap participation and what it means for patients.

An early benefit of having this information upfront is reducing ‘bill shock’. Also dubbed ‘financial toxicity’, this phenomenon has been strongly connected with subsequent non-adherence to treatments and forgoing of medical appointments1.

Enabling GPs to engage in more informed discussions with patients

A greater level of transparency allows healthcare providers to engage in more constructive conversations with their patients. In fact, a recent survey found that over 80% of GPs find gap participation data also helpful when making a patient referral decision2.

At the same time, informed discussions enable GPs and patients to create health care plans, which are consistent with their needs, values, and preferences. This level of positive engagement has been proven to influence the effectiveness of consultations, and result in better patient satisfaction and health outcomes.  

How HealthShare helps to bridge the gap

Digital health company, HealthShare, believes that greater transparency empowers GPs and their patients to make better health decisions.

As a “patient first” neutral partner for all stakeholders: health practitioners, hospitals, private health insurers and others, HealthShare provides a balance of information. Direct participation rates from health insurers are displayed and Specialists also have the option of publishing their own ‘No Gap’ and ‘Known Gap’ participation rates.

Freeing up more time to offer better patient-centric care

Studies have found that 69.5% of GPs report non-billable care. This consists of arranging referrals and consulting with specialists or allied health professionals, and can take more than ten minutes per occasion3. By decreasing the administrative side of non-billable care, HealthShare aims to help improve the efficiency of consultations and workflow for GPs across Australia.

HealthShare’s Referrals Directory also lists specialties, sub-specialties, practice locations, and has the ability to accommodate urgent appointments, languages spoken, qualifications, fees, and other relevant details in each practitioner profile. HealthShare’s Referrals Directory is made available to the public via www.healthshare.com.au and to GPs using MedicalDirector within their referral workflow. Its inclusion within MedicalDirector software makes it easier and faster to find the right Specialist for each patient’s needs.

Through the combination of direct data and comprehensive profile information, HealthShare and MedicalDirector are supporting open communication and supporting better heath consultations and outcomes. Increased traffic to the patient and GP channels since the inclusion of gap scheme participation data strongly suggests that Australians see the value in using this free service.

  1. Gordon, L. G., et al. (2016). ‘A Systematic Review of Financial Toxicity Among Cancer Survivors: We Can’t Pay the Co-Pay.’ The Patient-Patient-Centered Outcomes Research: 1-15.
  2. HealthShare General Practitioner Survey, May 2018
  3. Joan Henderson, Lisa A Valenti, Helena C Britt, Clare Bayram, Carmen Wong, Christopher Harrison, Allan J Pollack, Julie Gordon and Graeme C Miller (2016) ‘Estimating non-billable time in Australian general practice’
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