Australians have had access to universal health care for more than 30 years. However, our health care system is not immune to pressures of an ageing population, a growing burden of chronic disease, increasing life expectancy, increasing individual and community expectations, and escalating healthcare costs associated with new technology and treatments.
Many health care systems around the world are facing similar challenges and are looking to maximise the value of health care for populations, narrowing the gap between need and demand on one hand, and resources on the other.
This paper considers how value in health care is defined, outlining the opportunities that a value-based approach to health care offers in transforming health system focus from volume to value. It highlights the important enablers of value-based health care that are already present in Australia, and the barriers to adoption. It considers the application of international experience in value-based health care in an Australian context. In particular, it considers the unique challenges of translating learnings from other national health systems to Australia and its universal health system with objectives relating to equity and affordability.
The creation of value in partnership with patients is acknowledged as being central to implementation of value-based health care, and includes both agreeing on and measuring outcomes. Data to enable measurement of outcomes, cost and variation, are key to the creation of value, and also to establishing funding mechanisms that support a value-based approach to care. Case studies describe some current initiatives under way in Australia, but international experience suggests that a national strategy is required to effect transformation at scale.
The paper makes recommendations for enabling value-based health care through public policy in Australia. These include:
- A national, cross-sector strategy for value-based health care in Australia
- Access to relevant and up-to-date data
- Evidence for value-based health care in the Australian context
- Health workforce strategies supporting models of care that embrace a value-based approach
- Funding systems that incentivise the delivery of value-based health care