FOR HEALTH FUNDS

With our advocacy, your members can concentrate on their health. We give them choice and a sense of control by providing the information and support they need to navigate their own path — whether that be before going to hospital, during their time there, or after they leave.

From care coordination and in-home nursing, right through to allied health and carer services, we partner with families, medical teams, and communities to assist our clients in maintaining their independence.

Your Health Navigator was established in South Australia by two registered nurses with professional experience in community and hospital substitute care. Both nurses identified the need to provide better care pathways for patients at home, together with measurable effective outcomes. Through various programs, Your Health Navigator has been providing extensive, high quality in-home healthcare to patients across Australia since 2015.

Your Health Navigator is accredited through the Australian Council on Healthcare Standards Equip 6 program, which exceeds the requirements of hospital substitute providers under the Private Health Insurance Legislation.

At Your Health Navigator, our focus is to provide pathways of care which have the best possible outcomes for our patients. Our values, ‘Respect, Respond and Connect’ underpin everything we do and our multi-disciplinary teams work together to navigate and support our patients on their healthcare journey. Our core purpose is to achieve optimal health outcomes, manage chronic conditions and reduce hospital length of stay together with re-admissions. We also endeavour to assist patients in accessing appropriate community and government funded services.

We work in partnership with private health insurers such as Health Partners, to deliver in-home services to members (who have a referral and who are eligible). This video shares Janice's Rehabilitation in the Home story:

Eligibility criteria and waiting periods apply.

Our Values

RESPECT

We work in partnership with our patients, their families and funders to develop personalised care plans. We listen and understand the importance of involving the patient in all decisions pertaining to their care. We discuss appropriate care options, allowing patients to make informed choices. We believe every person has the right to be treated with empathy and respect.

RESPOND

We recognise that all patients have different needs which is why we provide a responsive and flexible 24-hour service operated by experienced clinicians.

CONNECT

We realise the importance of independence and where possible and appropriate, connect patients with local community providers to help them to remain living safely at home.

How can we assist your health fund?

With a proven track record of providing care for members of several health insurers, we can complement your member experience, product offering and claims management by assisting you in managing your members’ health journey. This helps to provide quality hospital substitute care and engages both the fund and member in their care options.

Health Fund Relationship Managers

We provide a Relationship Manager to ensure your health fund will have a one-point contact to Your Health Navigator clinical staff. Our Relationship Manager will communicate any services, concerns or patient care plans to make certain communication lines are always open and transparent. If any question is raised about client eligibility, the fund will be contacted for discussion prior to approval and entry into a program.

Health Link Hospital at Home Program

Our Hospital at Home Program offers Hospital Substitute Treatment (HS-T) which is a clinical alternative to being treated in hospital. The program also supports early discharge from hospital where treatment and support can be provided for the following services:

Complex wound care
IV antibiotics
Negative pressure therapy

These services are in home services, not hospital services, provided by Your Health Navigator nurses and clinical staff. All services are coordinated with the patient’s treating GP, specialist, hospital and health insurer.

The Health Link Programs can also be extended to the following services and can be tailored to the needs of a health insurer:

Diabetes Program
Medication Risk Assessments
Balance/Falls Prevention Program
Health and Wellbeing Program
Hospital Assessment Care
Wellbeing Support Program

Let's talk about how we can work together and engage your members throughout their health journey.

REFER TO US

Health Link Joint Care Program

Your Health Navigator, through the Australian Health Service Alliance (AHSA), is extending our Health Link Joint Care Program to any health funds that would like to participate. This program supports members’ rehabilitation needs and promotes the best possible outcomes before and after joint surgery.

There are two tiers under the joint care program that can be provided by Your Health Navigator and each tier provides a range of different bundled services relevant to the patient’s needs.

The Health Link Joint Care Program provides:

Better health outcomes tailored to patient’s needs, before and after joint surgery
Patients with choice for their treatment and assistance to reduce their length of stay in hospital and readmissions
Access to a Your Health Navigator liaison coordinator, linking the patient, hospital, allied health and primary healthcare providers
Services for joint recovery and rehabilitation services at home
Access to a registered nurse via our 24-hour phone service throughout the program
App technology for ongoing physiotherapy services
Reporting of outcome measures which are gathered throughout the program
Healthcare navigation to the community, My Aged Care or CHSP funding

How do referrals to the program work?

Your Health Navigator staff work closely with the health fund to identify members who may fit the eligibility criteria to participate in the program. Over the years, we have built strong relationships with GPs, surgeons as well as hospital admissions and discharge coordinators. The following referral channels and processes are already in place:

Health fund referral
Hospital referral
Specialist and GP referral

Financial Eligibility and General Inclusions/Exclusions

Our clinical staff determine the patient eligibility and understand the principles under a Your Health Navigator Hospital Substitution Treatment (HS-T) or agreed bundled model of care. This allows for consistency and equity of access for members of all individual health funds.

Your Health Navigator programs of care are financed by the patient’s private health insurer. Only HS-T programs that have been approved by the health fund are eligible for funding. This is dependent on the service level agreements with individual health funds or groups.

Principles of Your Health Navigator Care

Client centered care: The member is engaged in all care and treatment decisions.
Voluntary member participation: The member has provided informed consent and understands the care plan, including that the service may be withdrawn if their medical condition changes and they would be at risk of an adverse outcome. The member is made aware that their medical record may be viewed by the health insurer for audit purposes (dependent on service level agreements).
Specialised nurses and allied health providers: Care is provided by an experienced and competent workforce.
Equitable care: Care is delivered in equitable and sustainable ways.
The member has access to support 24 hours a day, seven days a week.
The member should not be financially disadvantaged by being admitted to a Your Health Navigator program.

Our team care about making an impact, both in our clients’ lives and in the way the health system responds. By working with people in a meaningful and mutually respectful way, we are changing healthcare for the better. We empower your members to manage their own recovery journey. And it’s our privilege to be right there alongside them.

Click on the below links to learn more:

Wondering how our programs work on a practical level?

Download our Client Case Studies here