There’s no place like home – reforming out-of-hospital care

31 May 2023Policy & Research

A significant refocus of Australia’s health system on the provision of healthcare outside hospital settings will be critical to its long term sustainability, and ensuring it meets the demands of 21st century Australia, a landmark report has found.

Private Healthcare Australia (PHA) today released its There’s no place like home – reforming out-of-hospital care report which found prioritising access to “out-of-hospital care”, will unlock value for patients and the health system more broadly, by offering the choice of flexible care for patients while also relieving system pressures.

The reforms proposed in the report will improve healthcare access, reduce the burden on hospitals and the public health system and deliver savings of $1.8 billion, taking pressure off private health insurance premiums.

The report identifies archetypes for out-of-hospital care that can be delivered now, ranging from short stay surgery to mental health and substance use disorder management, short acute interventions like wound care and chemotherapy, to end-of-life care.

Currently, private health insurance involvement in out-of-hospital care is restricted to funding or providing a limited number of hospital-substitute and chronic disease management programs under the Private Health Insurance Act 2007. This limits patients’ ability to access to high quality care and restricts the choice of where they can receive services.

Recommendations to achieve necessary change include:
Recognition of the impact on the workforce, who trained largely work in an institutional setting; doctors must be appropriately compensated for changes in clinical practice and business models. Address regulatory barriers embedded in outdated legislation; for example, a prescribed list of practitioners able to deliver out-of-hospital care which excludes GPs, nurses and mental health workers must be removed; and Medicare rebates will need to be adjusted to reflect new ways of working in the community. Rapid assessment of new technologies which enable data sharing and patient monitoring to ensure they are secure and cost-effective. Federal and State governments need to have appropriate standards in place to ensure the quality and safety of new services and to create an effective barrier to entry for substandard providers.

Recommendations to achieve necessary change include:

Recognition of the impact on the workforce, who trained largely work in an institutional setting; doctors must be appropriately compensated for changes in clinical practice and business models.
Address regulatory barriers embedded in outdated legislation; for example, a prescribed list of practitioners able to deliver out-of-hospital care which excludes GPs, nurses and mental health workers must be removed; and Medicare rebates will need to be adjusted to reflect new ways of working in the community.
Rapid assessment of new technologies which enable data sharing and patient monitoring to ensure they are secure and cost-effective.
Federal and State governments need to have appropriate standards in place to ensure the quality and safety of new services and to create an effective barrier to entry for substandard providers.

View PHA’s report: There’s no place like home – reforming out-of-hospital care

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