Current national health policy emphasises costly and unsustainable scaling up of healthcare volume and perpetuates ongoing inequities in access to care. The Commonwealth Government’s Long-Term National Health Plan includes commitments to support flexible care models that do not rely on fee for service, as well as the development of a national preventative health strategy. However, without clear policy levers to measure and fund meaningful improvements in health outcomes, national efforts to achieve a vision of ‘a mentally and physically healthy Australia’ are likely to be hampered.

A number of recommendations are made for improving health within efficient costs on a national scale.

• The National Health Agreement and related National Partnership Agreements must establish mechanisms to develop and report on health outcome indicators.
• A national framework for outcome-commissioning accompanied by an Implementation Plan to progressively shift toward an outcome-focused health system should form part of a reformed National Health Agreement.
• Mandatory development and linkage of health outcome data should be embedded in all national partnership reporting requirements, to be held in a national health outcome data repository under centralised custodianship.
• The Australian Commission on Safety and Quality in Health Care (ACSQHC) of validated patient-reported health and experience outcomes directory should be supported for initial work and ongoing development
• National metadata architecture should be used across all national health data collections to facilitate linkage and modelling.
• Modelling of unwarranted variation in healthcare and differential costs of care should be mandated for all bilateral and multilateral funding agreements, commencing with existing data collections from activity-based National Partnership Agreements on healthcare currently in the Commonwealth’s possession.
• Governing agreements for national healthcare funding should be revised to mandate independent cost modelling for all bilateral or multilateral health agreements and should mandate efficiencies through population-based prevention and mitigation of disease.