Responding to Changes in Funding and Payments

Responding to Changes in Healthcare Funding and Payments: With expected MBS review outcomes and follow-on changes in funding and billing in healthcare there is potential for some notable changes in the business and service models of healthcare. With a focus on funding changes to build robustness and system sustainability, address specific patient cohort treatment needs, and provide access to more services in the home or community settings there is the potential for considerable change in the way healthcare is accessed and delivered. Where is the potential for innovation in the evolving models of healthcare funding and billing? Can we do more irrespective of funding?

Insights

Our key take-away as participants and observers at the event were:

  • Not just to think about new ideas for health system improvement and change, but more
    importantly how to implement those changes. Funding and payment models have the ability
    to stifle change or to stimulate system innovation.
  • In any future funding and payment model we would need to separate the assessment from
    the provider to ensure appropriate governance and minimise opportunity to game the system.
  • Regional and community led approaches are where we can best be innovative and stimulate
    change. Stimulating regional innovation and change should be a key focus for policy change.

    • Are there ways to intelligently use Primary Health Networks to support these changes?
  • Decision makers are making incremental changes that are smart within the confines of the
    current system and operations, rather than radical changes to address system sustainability.
  • Need to be more customer focused from now on. If not we will get limited outcomes.
  • System innovation is hard in healthcare because of the complexities and multiple competing stakeholders. Funding and payment mechanisms have the ability to change the way system
    works with incentives. This requires political drive and will to change.

 

Find out more

Innovation Guide

Jeremy Sammut

Vishaal Kishore

Dr Jeremy Sammut, a leading advocate of market-based health reform, will set the scene and explore the opportunities for change and innovation within the current and future funding and payment models. Dr Sammut provides independent advice on healthcare funding and economics with the Centre for Independent Studies based in Sydney and is well placed to guide the discussion. The session will build a logical approach to potential policy changes that could be made, whilst looking to emerging funding models that are already being trialled, with a view to proposing funding and payment changes across health and social welfare sectors. We will look at the opportunities that digital enables in being innovative as well as thinking differently about health funding and payment constraints.

Resources

Do No Harm

Healthcare is a complex system where the general mind set is at first, ‘do no harm’. Traditionally, we require an evidence base to prove models and to implement change to ensure that it is based on peer review knowledge and experience. The trouble with this approach...

read more

Videos