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Team Genesis Healthcare

Team Genesis Healthcare

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Published by: snguidemynah on Apr 20, 2012
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03/12/2014

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1. Topic and Government Agency in charge
 Healthcare. Government agencies in charge: Health Promotion Board (HPB) and Ministry of Community Development, Youth and Sports (MCYS).
2. Background information
Singapore is facing an ageing population crisis that will only be more apparent in the comingyears. The dependency ratio continues to decrease from 7.2 in 2010 to 7.0 in 2011
i
. By 2020,the number of Singaporeans aged 50 and over (“Seniors”) is projected to reach 1,992,000
ii
.With healthcare costs expected to increase, there is an urgent need to build a comprehensivehealthcare framework in order to support the growing number of Seniors and managehealthcare costs.
2.1. Existing Policies in Place:
While the existing initiative, People Association’s
“WellnessProgramme”,
encourages active ageing, there is a lack of incentives for Seniors to take partin the many activities or interest groups on a consistent basis. Another existing policy,
Community Health Assistance Scheme (CHAS),
subsidizes the primary healthcare costs of the Seniors, but does not encourage Seniors to take ownership of their own health. Therefore,a two-pronged approach is needed to address each policy’s gap by not only providingfinancial incentives but also encouraging Seniors to proactively take charge of their healthand well-being.
3. Key Objectives and Issues
 
Our policy’s key objective is to promote healthy ageing in Seniors by enhancing theirquality of life, helping them cope with rising medical costs and instilling independence.
 From this, the key issues that arise are firstly, how to encourage a healthy lifestyle? Secondly,how to strengthen the social safety net for Seniors in addition to the existing health policies(i.e., MediShield and MediSave)? Lastly, can Seniors play an active role in propelling the programme forward, achieving the sustainability goal of “By the Seniors, for the Seniors”?
4. Recommendations & Rationales - LifeMed
 The existing PA’s “Wellness Programme
iii
” (Budget 2009 and 2011
iv
) maintains an emphasison active aging by encouraging seniors to participate activities such as volunteerism, lifelonglearning, inter-generational programs, and fitness activities. To improve on this existing programme and also achieve the above stated key objectives, an overarching health policywill be introduced. This policy will introduce a fund, LifeMed, that is sustained through “LifeCredits” given for participation in social activities. In addition, the policy encourages group participation by granting additional “Credits” when seniors participate in groups. The creditsaccumulated can then be used to subsidize medical expenses.An increase in involvement in community activity by the Seniors will prevent or delay theonset of chronic disease and increase healthy life expectancy level, and in turn, manage the burden of increasing healthcare costs. This policy is therefore centered on promoting ahealthy and active way of life. Succinctly put, our policy aims to bridge the objectives of MCYS and HPB by amalgamating the benefits of the Wellness Programme and CHAS whiletackling the deficits of each respective policy.
All Singaporean or Permanent ResidentSeniors above the age of 50 will be in this policy unless they choose to opt out.
 
5. Mechanism/ Implementation of LifeMed:
 The mechanism behind LifeMed will be illustrated through the following example: Senior A(“A”) decides to participate in a cooking class at a community centre (CC). A will need
 
his/her NRIC and relevant documents upon registration. The administrator will key in his/her  particulars into an integrated LifeMed system which tracks the activities that A has signed upfor. At the end of the cooking class, credits will be added to A’s account in the system. Thesecredits can then be used for A’s medical expenses and other health expenditures namely, primary care and other illnesses listed under the existing Community Health Assist Scheme(CHAS). Using the LifeMed System, administrators at medical institutions will know theamount of “Credits” balance that A has and can advise A on the option to use them offset hismedical expenses.The LifeMed System is an integrated information system which links the CCs with HPB andhealth institutions, i.e hospitals and polyclinics. The LifeMed System can tap onto theElectronic Health Record (EHR) system
v
to facilitate the administration of credit transfer andusage. Thus, in addition to their personal medical information, information on the LifeMed’sactivities and the LifeMed Credit can also be tracked in the EHR.
Credits Rates & Limits (Table 1):
 
Activities:
The activities under consideration have to be from the following institutions includingPeople’s Association, Community Centres, Approved Voluntary Welfare Organization (i.e.SAGE
vi
) and other institutions approved by MCYS and HPB.
Features of the policy:1) Credit Limit
 As this policy aims to focus more on the low-income Seniors, there will be credit limit put in place according to the type of housing. The type of housing provides a reasonable gauge of income level and as well as allow for easy implementation. The Seniors will be segregatedinto 3 different groups which correspond to different “Credits” limits (Table 1). The low-income Seniors will have the highest “Credits” limit and thus, provides a greater incentive for them to participate in the policy and also indirectly relieves their medical expenses burden.
2) Group Incentives
 To promote cohesion and foster long-term relationships between Seniors, a group incentive isintroduced to encourage seniors to join activities in groups. Through the network effect, thegroup incentive aims to ‘push’ active Seniors to rope in those inactive Seniors, and thereforeensure the continuous increase in participation rate of activities.
Mechanism:
When a groupcomprising of 4 or more Seniors participate in an registered activity together, each Senior inthe group will enjoy an additional $10 “Credits”. However this is not applicable for freeactivities.
3) Other features
 Firstly, the funds cannot be withdrawn by the Seniors and can only be used to pay for theSeniors medical treatment or other qualifying expenses. Secondly, the accumulated creditswill be rolled over indefinitely and be available for life. Thirdly, the “Life” credits are non-transferable and non-convertible to cash. Also, upon the passing of the Seniors, the credits
 
will be removed from the fund of the Seniors. Lastly, the fund can be accumulated on anannual basis, but restricted to annual credit limit.
6. Implementation:
 The entire policy will be comprised of three phases which spanning a minimum of 15months. Firstly, the LifeMed system, will be set up within the next 9 months. The second phase will be a pilot phase, where the policy is implemented under a few selected CCs where participation rate is relatively low and where there is high concentration of Seniors. Thirdly,after a 6 month review of the pilot phase, the credit system will be rolled out to all CCs for allSeniors in Singapore.
How Our Proposal Fills the Existing Gaps
 1) The usage of the “Credits” incentivizes the Seniors to take the first step to participate insocial activities where they can make friends and after which, continue to participate activelyin social activities. Together with the group incentive feature, active Seniors can rope in theless active ones through word-of-mouth, facilitating the creation and growth of social unitswithin the community. Within the social units, Seniors can help to monitor fellow Seniors’lifestyle, provide mutual support and encouragement.2) By introducing different credit caps according to housing types, our policy will help thelower-income Seniors while still encouraging other Seniors to participate. Through a higher credit cap for the lower-income Seniors, the policy aims to boost participation rate among thelower income Seniors and provide more financial assistance for them.3) The “Credits” system will enable Seniors to ‘earn’ credits through participation inactivities. This encourages senior citizens to take greater responsibility of their lifestyle andtheir health.
7. Desired outcome/ Key Performance Indicator (KPI)
 
Participation Rate:
This program will be able to increase the level of participation incommunity activities among the Seniors. This also helps the elderly in becoming an integral part of the society since it creates more opportunities for interaction among the young andold. The policy’s KPI is to achieve a participation rate of 70%, engaging over 900,000 participants aged 50 and over by 2017.
Reducing low-income Seniors’ medical costs:
In order to help the low-income Seniors better cope with rising healthcare costs, this program will provide more assistance towardsthe lower income group through a higher credit limit as compared to the middle and higher income group. Therefore, this policy is able to reduce their burden of rising medical costs.
Cost Savings:
With an increase in activity, likelihood of illness falls, and thus alleviates the problem of rising health costs
vii
. According to an analysis conducted by the U.S. Centers for Disease Control, it is estimated that a one-dollar investment in measures to encouragemoderate physical activity leads to a cost saving of $3.2 in medical costs. Thus, we estimatethat the government will be able to save a minimum of $1 billion dollars in medical costswith a $500 million investment into the policy.
Health Development Index:
Singapore is ranked 26th out of 187 countries for the UN’sHealth Development Index in 2011, with an index of 0.866. With healthy life expectancy projected to increase and the delay in the onset of chronic diseases resulting from the policy,Singapore will be able to ascend up the ranking considerably by 2017.

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