Bupa backs new report calling for reforms to address 'headwinds'

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A new report has recommended 19 reforms to the health system it says could help address the "many headwinds, including an ageing population and the rising burden of chronic disease."

The report, Ensuring the Sustainability of the Australian Health System, has been developed by Global Access Partners (GAP).

It summarises the outcomes of discussions by the 'Australia’s Health 2040 Taskforce' – a strategic policy group co-funded by GAP, EY, Bupa Health Foundation, Johnson & Johnson Australia and Westpac.

According to the report, "Australia’s healthcare system has consistently achieved excellent health outcomes at a relatively low cost, ranking amongst the top countries in the world for overall health status."

"Through both Medicare and Australia’s private healthcare market, Australians have seen improvements over the last few decades in many process measures (e.g., decreased time to access services) and outcome measures (e.g., improved life expectancy)," it says.

However, the report says the existing fee-for-service model is increasingly inefficient and creates few incentives for healthcare practitioners to contain healthcare spend while working to improve patient outcomes.

The report's 19 recommendations are grouped around four broad objectives - improve health outcomes with an emphasis on quality of life, improve equity of outcomes, appropriately balance cost-effectiveness, sustainability, safety and quality, and enhanced transparency around outcomes rather than inputs.

One of the recommendations is to pool-funds through a private-public partnership, incorporating primary health networks, Medicare, private health insurance, and federal and state funding. 

The report says the pooled-funds could be used to develop innovative models of care, including by leveraging outcome-based payments for either specific patient cohorts or episodes of care, to strengthen the incentive for case management and hospital avoidance activities.

In terms of transparency, it recommends the creation of a National Centre for Healthcare Innovation and Improvement as a public-private partnership.

"A national centre, bringing together the best elements of the public and private sectors, would support system stewardship by testing and scaling up new models of care and payment systems, build capacity in the commissioning work of Primary Health Networks (PHNs), and spearhead national efforts to support the development of clinical and consumer skills in leadership, change management and improvement science," it says.

It also recommended standardising reporting on various patient outcomes nationally as a way to improve system transparency, increasing the contestability of health services, and ensuring collaboration between private health insurers and the Commonwealth on payment integrity.

Bupa Managing Director, Dr Dwayne Crombie, said the insurer welcomed the report and its focus on patient-centred care.

"Affordability is a major concern for the health system and we need to prioritise delivering the right care, at the right time, in the right setting," he said.

"Cost pressures driven by the ageing population aren’t going away, so it’s critical that the health sector works together to ensure long-term sustainability."